Garth Rattray | Beware of ‘tech neck’

Our modern way of life has many positives, but it also comes with numerous pitfalls. Modern living takes a heavy toll on our cardiovascular system, nervous system, alimentary system, and our musculoskeletal system.

The necessary use of hand-held devices that combine communication, entertainment, educational, and image-capturing capabilities with a very sophisticated computer, puts a huge strain on our necks. So, too, does using a laptop, mini-laptop, [electronic] tablet, or a ‘workstation’ for extended periods of time.

In 2008, United States (Fort Lauderdale) chiropractor Dr Dean L. Fishman coined the phrase “text neck” to describe the deleterious effects on our necks when we habitually look down at electronic equipment for a long time. In those days, texting was the thing. However, now, we do a lot of various modes of communication and several other technical tasks that have us flexing our necks for hours on end, cumulatively. So the term was modified and is now referred to as “tech neck”.

Flexing our necks for prolonged periods may seem innocuous, but it is not. It is a very unnatural posture that leads to damage of the musculo-skeletal (soft tissue and bony) structures of the neck. That kind of flexing will cause permanent damage.

Dr Fishman described tech neck as occurring as the result of “… repetitive stress injury resulting from excessive, sustained, forward-flexed head positions” while using [any and all] tech devices.

Your neck has seven bony vertebrae (with their joints) and is called the “cervical” region from the Latin word for neck, “cervix”. Incidentally, all mammals (warm-bloodied animals) have seven bones in the neck. This includes whales and giraffes. You also have several muscles (with their tendons). You have many ligaments.

Except for the first two vertebrae, you have intervertebral fibrocartilaginous discs between the vertebrae. These ‘spacers’ allow for shock absorption, flexibility, cushioning, and support. They have a strong outer ring (to hold the core and handle physical stress) and a jelly-like inner core (for shock absorption).

It is bad enough that over time, the outer ring of our intervertebral discs degenerate, desiccate (‘dry out’). Bad posture accelerates disc degeneration. This can cause loss of structure of parts of that essential ring. When this happens, the soft inner pulp can bulge through the gap and impinge or compress the sensitive nerves nearby. People call this event, “slipped discs”. However, they don’t ‘slip’. They bulge, herniate (also referred to as “rupture”) like any other hernia.

The problems caused by flexing the neck for long periods has to do with mechanics. The average human head weighs between 4.5 kg and 5.4 kg when we are in the neutral position. But when we tilt our head to look at a screen, the pressure on all our neck structures increases significantly.

When we are in the neutral position, the weight of our head is transmitted straight down our spine. However, a mere 15-degree forward tilt puts an unnatural pressure, equivalent to about 2.4 kg, on our neck structures. That unnatural pressure increases to 18 kg with a tilt of 30 degrees, 22 kg with a tilt of 45 degrees, and a whopping 27 kg (about 60 lbs!) with a tilt of 60 degrees. That is scary.

That kind of [unnatural] sustained pressure causes problems with our muscles in the neck, shoulders, and upper back. They become fatigued, tight, and leads to pain. Compression of the intervertebral discs accelerates the degeneration process, causes loss of functional integrity of the discs, bulging, and loss of [natural] disc height. The loss of proper disc support causes stress on the intervertebral joints, so they undergo degeneration /arthritic changes. Additionally, abnormal bony spurs tend to appear. The spaces where our nerves exit the spinal canal (the foramina) become narrowed and can squeeze the nerves.

The bulging discs often squeeze the structures of the spinal cord and/or the nearby nerve roots. That can lead to tightness ‘knots’), cervico-cranial headaches, localised neck pain, pain going down the entire upper limbs, tingling (pins and needles), numbness, and even weakness.

When the spine is in the natural (neutral) position, it is referred to as ‘lordosis’. The word comes from the Greek word lordos, which means “bent backward” or “bent forward” – in reference to the inward curve of the spine. It is very important that the lordotic curve is maintained, but unnatural forces on the spine lead to loss of that curve. The cervical spine flattens (becomes too straight), causes misalignment, and increases pressure on the discs. The resulting [chronic] problems may lead to poor posture (that will exacerbate neck troubles) and require medical interventions like physical therapy and perhaps even surgery.

Little children are very susceptible to tech neck because their heads are relatively larger in relation to their necks and the rest of their bodies, and their spines are not fully developed. Further, there are children who spend many waking hours bent over screens because their parents use tablets and phones to distract them, educate them, and ‘babysit’ them.

You can avoid tech neck by looking ahead and taking breaks while using your device. There are several mobile apps that monitor your posture, alert you of poor posture while holding your device, and provide exercises to reduce neck strain. Ergonomic workstations are very important. The goal is to be able to be sitting upright and looking straight ahead at the computer screen.

Tech neck (also called ‘text neck’ or ‘forward head posture’) is a modern-day epidemic that deserves far more attention.

Garth Rattray is a medical doctor with a family practice, and author of ‘The Long and Short of Thick and Thin’. Send feedback to columns@gleanerjm.com and garthrattray@gmail.com.