There may be a unique solution for patients struggling with neck pain caused by chronic technology use, according to an expert.
As Harmony Healthcare IT recently revealed from a survey including more than 1,000 people in the United States, screen time is up 14% from last year. Americans are now spending an average of 5 hours and 16 minutes per day on their phones, according to the results.
Notably, the younger the respondent was, the more screen time they were likely to use: baby boomers were on their phones for an average of 4 hours and 19 minutes per day, but members of Generation Z used their phones for about 6 hours and 27 minutes per day.
This chronic technology use can create orthopedic issues — namely, tech neck, according to the University of Alabama Birmingham (UAB). Although “tech neck” is not an officially recognized medical term, the impact can be very real. Correct posture is the equivalent of lifting 10 to 12 pounds, but tilting your neck just 15° forward makes it like lifting 27 pounds. The further the head drops, the larger the burden: tilting your head 60° forward is the equivalent of lifting 60 pounds with your neck, according to UAB.
Regularly keeping the head and neck tilted forward can lead to back, shoulder and neck pain; limited upper body mobility; tension headaches; body aches; rounded shoulders and even migraines, according to UAB.
Healio spoke with Rahul Shah, MD, an orthopedic spine surgeon at Premier Orthopaedic Associates, to learn more about tech neck and how interventions like adult tummy time can make a difference for patients.
Healio: Can you explain “tech neck” and “adult tummy time?”
Shah: When you are looking at your devices, you are typically in a position where you’re basically stooping down and craning your neck forward. Instead of the head being level over the shoulders, which are then level over the pelvis — like when we stand or walk — when you’re looking down at this device, you’re tilting your chin down. That tends to lead to fatigue of the neck muscles in the back and the upper shoulder muscles, because they’re basically in a tug of war where your eyes and your attention are forcing you to crane down and the rest of your body wants to bring your head back over the shoulders.
That fundamental tug of war can result in an imbalance and cause neck aches and things of that nature. Now, as we’re younger, we’re able to accommodate that posture more easily and work around it. But as we start to get a little bit older, or as we start to get more involved in our jobs and these periods of time last longer, we sometimes have difficulty with the neck ache causing more problems.
The challenge going forward is how do we address this? We’ve come up with different ideas. One of the things that seems to be getting a little bit more popular, especially in the social media world, is to say, “Well, if you’re craning your neck forward and looking down all the time, what’s the opposite of that? Why not just get on your belly and have your head rest in that manner so it kind of relieves the neck?”
There’s a lot of common sense behind that. But the reality is, is that the right fit for you or me? Individually, what’s the scenario and how do we judge that? There are no real parameters around how far we’re craning when we’re looking forward with our tech neck, and no real parameters about how much we should be relaxing the neck or how much time we should be spending on our bellies for adult tummy time. It’s good to understand what’s going on fundamentally at the time of the neck ache — which is occurring from our neck being stretched forward or strained or craned forward — and what we can do to get around it.
The reality is, the muscles in the back of the neck and the shoulders have to be activated so that they can have enough blood flow going to them so that they’re able to assume their natural posture and alleviate that craned area. In my experience, this is better achieved from more active scenarios, like doing isometric neck exercises where you push your head forward with your palm, over your forehead, back of the head, then over the right ear, and then over the left ear to activate the blood flow into the back of the neck so that the head is in a more comfortable position and finds its own sweet spot as to where the muscles can handle it.
A second option is to increase your aerobic activity. In general, going for a walk — potentially doing any type of zone two cardio activity — should help increase the blood flow all throughout the body, including those big muscles that are behind the shoulders, behind the shoulder blades, into the neck and into the lateral muscles. That will then help to improve your posture and keep your head centered over your shoulders and your pelvis, increasing the natural position of the muscles, so there’s less fatigue on those muscles. You’re not craning them as much.
If you have been craning your neck for some time and you want to go onto your belly or to try to cradle the head by laying down, it’s reasonable, but I don’t think it’s a cure all kind of scenario. Let’s say you have X amount of time for being on a tech neck, should you then have Y amount of time to counteract it being on your tummy? I don’t think that’s a very good trade-off. I think a better trade-off is if you find that being in a prolonged position with your neck gives you a neck ache, you should do some increasing activities to try and drive the blood flow to the muscles.
Healio: Why are these important concepts for primary care providers to know about?
Shah: Up to 30% to 40% of visits that a primary care provider sees every year are because of some type of back or neck ache, so this is very common. If you’re seeing 25 or 30 patients in a day, and a good portion of them have this type of problem, you want to know about what’s happening to try to drive that concern.
And patients all manifest with different types of aches. Some have a tech neck and an ache that occurs from their shoulder blades. With neck pain, some of them come with the inner half of shoulder blade pain. Some people can have difficulty with the front of their neck. These myriad problems can potentially be addressed by looking at these different solutions that we’ve talked about.
In addition, when anybody comes in — because nobody gets a doctor’s appointment within 5 minutes of when they book it — everybody’s going to go online and look at where things are. And now that there are many more suggestions — like tummy time — that are generated on the web that sound very good, it’s very important for a PCP to know about these because these trends may be potentially helping or they may be potentially harming. Understanding that context allows a PCP to give the best context-laden solution to be able to meet whoever they’re taking care of on their journey, to help them at their specific moment in time.
Healio: What benefits does adult tummy time offer? Does this actually work for adults?
Shah: That’s a very good question, but a very difficult question to answer. I think in general, it can give you some reprieve of your neck ache, especially when you have a significant amount of time where you’ve basically overdone it and all the muscles in the neck are either significantly stiff or have problems. It’s a good way to try to stop the irritation of the muscles. However, it may not be enough to fully augment or fully restore someone to having a pain-free situation.
If you lean into just doing adult tummy time, that may not be the best solution. And, in fact, you may have to go from having tech neck, where you have neck ache and have a stiff neck, to shoulder blades pinching in the neck. And then you can, from there, start to walk around as much as you can to increase the blood flow to the muscles in the neck. Because, at the end of the day, that is likely the most effective immediate solution that you can get while you’re understanding and trying to get additional treatment with your PCP or with additional physical therapy or chiropractic care.
Healio: What are some ways to fix posture and prevent tech neck?
Shah: There are so many different ways that we irritate our necks. I think that the go-to would be to try to take breaks so you’re not overloading the neck. Setting a timer to help yourself with those scenarios is sometimes helpful, just so that you’re not in one activity for a prolonged period.
However, let’s say you’re a coder, or you’re doing something where you need to be locked in. You need to be in that tunnel of really getting everything done and, honestly, interrupting yourself with breaks is not a viable solution. In that scenario, getting something where you’re not craning your neck is a good idea. Using stand-up desks, elevating someone’s chair, making sure that they’re not tipping their neck too much more than 15° when they’re looking down — those are all reasonable places to start.
Once that’s done, it’s a good idea before you get started to go for a walk to really increase that activity of the blood flow to those muscles — maybe doing some isometric exercises. And then afterward, have some type of cool down period. Those are all things that you can do to try and help yourself without necessarily changing what you do or changing the output of the work that you do.
Healio: What is the take-home message for PCPs here? What should they be telling patients?
Shah: First of all, you’re not alone. This happens to a lot of people, and we have some pretty good ideas on how to get started. Tech neck is something that you should be aware of, and something that you should be paying attention to.
Our go-to solution here is to modify your exposure of putting the device in a bad position where you’re craning or overloading your neck. You want the skills of what your neck can handle to be well tailored to the challenges of where that device is. So, alter that dynamic, if you can, and then focus on increasing the neck health — or the muscles around the neck — to get them better by doing aerobic activity, increasing the muscle strength around them with the isometric exercises and work in that area. Though tummy time is an option, it’s more of a sort of stopgap scenario as compared with something that you should be doing all the time.
Rahul Shah, MD, can be reached at info@poasnj.com.
