Text neck is not an official medical diagnosis, but rather a term commonly used for a repetitive stress injury where excessive texting or mobile device use is believed to be the primary cause. A doctor or other medical professional typically identifies text neck pain after a physical exam and patient history are taken, including a review of the symptoms.
Common Symptoms Associated with Text Neck
Text neck symptoms commonly include one or more of the following:
- Pain in the neck, upper back, and/or shoulder. This pain may be located in one specific spot and feel intense or stabbing, or it may be a general achiness and soreness that covers a broader region, such as spanning from the bottom of the neck and into the shoulder(s).
- Forward head posture and rounded shoulders. Muscles in the neck, chest, and upper back can become deconditioned and imbalanced due to prolonged forward head posture. This deconditioning can make it difficult to maintain good posture with the ears directly over the shoulders.
- Reduced mobility. The neck, upper back, and shoulders may all experience some tightness and reduced mobility.
- Headache. Muscles at the base of the neck could go into spasm and become painful, or pain could also be referred from the neck up into the head. Excessive amounts of time looking at screens, regardless of posture, may also increase the risk for eyestrain and headache.
- Increased pain when neck flexion. Text neck symptoms tend to worsen when the neck is flexed forward into the position that originally caused the problem, such as while looking down and texting.
Where and how pain is felt can vary from case to case. For example, someone who primarily looks at a phone screen while using both hands (or no hands if it is lying on a table or lap) may be more susceptible to having pain evenly distributed on both sides of the neck and/or upper back, whereas someone who uses one hand may have more pain on one side due to using or straining those muscles more.
Less Common Symptoms Associated with Text Neck
Some other symptoms where the prolonged forward head tilting of text neck may play a contributing role include:
- Cervical radiculopathy. Symptoms of electric shock-like pain, pins-and-needles tingling, numbness, and/or weakness may radiate from the neck down into the shoulder, arm, and/or hand. Cervical radiculopathy can occur when a cervical nerve root becomes irritated or compressed, such as from spinal changes related to degenerative disc disease or osteoarthritis. Severe cases of text neck may accelerate or worsen this process.
- Balance issues. Prolonged amounts of time in forward head posture have been linked to reduced balance control, due to the head’s center of gravity migrating further in front of the body. This process can result in muscle imbalances and postural control changes in the neck and torso.
- Jaw pain. A misalignment in the cervical spine and/or muscle imbalances may lead to jaw pain, or temporomandibular joint (TMJ) pain.1
Other symptoms may also be associated with text neck.
Patient History and Physical Examination
When visiting the doctor with a primary complaint of neck pain, typically the first 2 steps involve:
- Patient history. The patient’s medical history, family health history, exercise and diet habits, medications, as well as current symptoms (and when they started) are reviewed.
- Physical examination. The neck is observed for any unusual posture or lesions, and palpated for possible areas of muscle tightness or tenderness. The head may also be gently guided through various ranges of motion to see if specific neck movements are restricted or alter the pain response (improve, worsen, or no change).
If the neck pain and/or stiffness is primarily caused by a repetitive stress injury, such as text neck or tech neck, enough information is typically obtained through a careful patient history and physical exam to make a diagnosis and start treatment.
If more serious causes of neck pain are suspected during the patient history and physical exam—such as nerve root compression, fracture, or a serious underlying medical condition—imaging and other tests may be required.