TEENS AND ‘TEXT NECK’

Teenagers’ com­pul­sive tex­ting on smartphones can cause in­jury to the cer­vi­cal spine, ex­perts warn.

Los Angeles Times - - SATURDAY - By Lily Dayton health@la­times.com

Dean Fish­man, a chi­ro­prac­tor in Florida, was ex­am­in­ing an X-ray of a 17-year-old pa­tient’s neck in 2009 when he no­ticed some­thing un­usual. The ghostly im­age of her ver­te­bral col­umn showed a re­ver­sal of the cur­va­ture that nor­mally ap­pears in the cer­vi­cal spine — a de­gen­er­a­tive state he’d most of­ten seen in mid­dleaged peo­ple who had spent sev­eral decades of their life in poor pos­ture.

“That’s when I looked over at the pa­tient,” Fish­man says. She was slumped in her chair, head tilted down­ward, madly typing away on her cell­phone. When he men­tioned to the pa­tient’s mother that the girl’s pos­ture could be caus­ing her headaches, he got what he de­scribes as an “emo­tional re­sponse.” It seemed the teen spent much of her life in that po­si­tion. Right then, Fish­man says, “I knew I was on to some­thing.”

He the­o­rized that pro­longed pe­ri­ods of tilt­ing her head down­ward to peer into her mo­bile de­vice had cre­ated ex­ces­sive strain on the cer­vi­cal spine, caus­ing a repet­i­tive stress in­jury that led to spinal de­gen­er­a­tion. He be­gan look­ing through all the re­cent X-rays he had of young peo­ple — many of whom had come in for neck pain or headaches — and he saw the same thing: signs of pre­ma­ture de­gen­er­a­tion.

Fish­man coined the term “text neck” to de­scribe the con­di­tion and founded the Text Neck In­sti­tute ( text-neck.com ), a place where peo­ple can go for in­for­ma­tion, pre­ven­tion and treat­ment.

“The head in neu­tral has a nor­mal weight” of 10 to 12 pounds, says Fish­man, ex­plain­ing that neu­tral po­si­tion is ears over shoul­ders with shoul­der blades pulled back. “If you start to tilt your head for­ward, with grav­ity and the dis­tance from neu­tral, the weight starts to in­crease.”

A study in the jour­nal Sur­gi­cal Tech­nol­ogy In­ter­na­tional quan­ti­fied the prob­lem: As the head tilts for­ward 15 de­grees from neu­tral, the forces on the cer­vi­cal spine and sup­port­ing mus­cu­la­ture in­crease to 27 pounds. As the tilt in­creases, the forces in­crease to 40 pounds at 30 de­grees, 49 pounds at 45 de­grees and 60 pounds at 60 de­grees.

“When your head tilts for­ward, you’re load­ing the front of the disks,” says Dr. Ken­neth Han­sraj, study au­thor and chief of spine surgery at New York Spine Surgery & Re­ha­bil­i­ta­tion Medicine. Though the study didn’t look at long-term ef­fects of this po­si­tion, Han­sraj says that, af­ter see­ing ap­prox­i­mately 30,000 spinal surgery pa­tients, he’s wit­nessed “the way the neck falls apart.”

He ex­plains, “When you’re ec­cen­tri­cally load­ing the spine, you’re go­ing to get cracks in the disks, slipped disks or her­ni­ated disks. This leads to steno­sis or block­age of the spine.”

In ad­di­tion, Fish­man says, text­neck pos­ture can lead to pinched nerves, arthri­tis, bone spurs and mus­cu­lar de­for­ma­tions. “The head and shoul­der blades act like a see­saw. When the head goes for­ward, the shoul­der blades will flare out … and the mus­cles start to change over time.”

Much like ten­nis el­bow doesn’t oc­cur only in peo­ple who play ten­nis, text neck isn’t ex­clu­sive to peo­ple who com­pul­sively send text mes­sages. Han­sraj says peo­ple in high­risk ca­reers in­clude den­tists, ar­chi­tects and welders, whose heavy hel­mets make them es­pe­cially vul­ner­a­ble. He adds that many daily ac­tiv­i­ties in­volve tilt­ing the head down, but they dif­fer from mo­bile-de­vice use in in­ten­sity and propen­sity.

“Wash­ing dishes is some­thing no­body en­joys, so you do it quickly. And while your head is for­ward, it’s prob­a­bly tilted at 30 or 40 de­grees,” he says. Peo­ple tend to change po­si­tion pe­ri­od­i­cally while read­ing a book, and they glance up fre­quently while hold­ing an in­fant. But mo­bile de­vices are typ­i­cally held with the neck flexed for­ward at 60 de­grees or greater, and many users, par­tic­u­larly teens, use them com­pul­sively. The study re­ports that peo­ple spend an av­er­age of two to four hours a day with their heads tilted at a sharp an­gle over their smartphones, amount­ing to 700 to 1,400 hours a year.

To rem­edy the prob­lem, Han­sraj has a sim­ple mes­sage: “Keep your head up.” While tex­ting or scrolling, peo­ple should raise their mo­bile de­vices closer to their line of sight. The Text Neck In­sti­tute has de­vel­oped the Text Neck In­di­ca­tor, an in­ter­ac­tive app that alerts users when their smartphones are held at an an­gle that puts them at risk for text neck ($2.99, avail­able for An­droid; in devel­op­ment for iPhone).

Fish­man also rec­om­mends that peo­ple take fre­quent breaks while us­ing their mo­bile de­vices, as well as do ex­er­cises that strengthen mus­cles be­hind the neck and be­tween the shoul­der blades in or­der to in­crease en­durance for hold­ing the de­vice prop­erly. He adds, “I’m an avid tech­nol­ogy user — and I use it in the proper pos­ture.”

Scott Gries­sel Getty Images/iStockphoto

HEAD BOWED over a mo­bile de­vice while tex­ting for long pe­ri­ods of time is a pos­ture that can even­tu­ally cause spinal dam­age.

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