text neck

Are you a victim of “Text Neck”?

At least now you have better surgical choices when you need corrective surgery.


Prepare for shocking headlines: habitual cell phone use can lead to a higher risk of spinal damage that may increase your chances for surgery later in life. Do you think I’m overly dramatic?


Think of all the things we do with our “phones” nowadays. Now think about who has one of these devices: kids as young as 8 and adults older than 88. And what do they all have in common? Increased stress on the spine from peering down – habitually – at that little glowing screen.


There was an article a few weeks ago that named “Text Neck” as a new problem for frequent smart phone users. The article quoted me asking, “will an 8-year-old need surgery at age 28?” Over the top? Are today’s young texters are tomorrow’s neck pain patients?


Consider that clinical evidence shows frequent phone increases stress on the spine. Any increased stress on the spine – especially if it is from repetitive motion or habitual posture – nearly always leads to chronic pain and possible corrective surgery. Where the spine is concerned, stress is everything.


My evidence is twenty-plus years of experience as a spinal neurosurgeon, and my patients from Cedars-Sinai Medical Center in Los Angeles and my practice in Beverly Hills. I see people from all walks of life who suffer from the effects of a lifetime of stress due to repetitive movement or just bad posture. The clinical evidence points to ANY constant source of stress on the spine can result in chronic pain in the spine, which may lead to ruptured discs and chronic pain. Without corrective modification of behavior or treatment (or both), the chronic pain that originates along the spine may be a symptom of degenerative disc disease which often does lead to surgery.


The problem with habitual texting (or constant phone use of any kind) is that it results in a deviation of the natural curve of the spine (lordosis) in the neck (cervical region). What this means is that clinicians such as myself are seeing more patients who show an abnormal cervical curve. The only explanation we can find for this “reverse curve” is from people who are looking down at their smart devices for hours every day. I can’t say that it is all due to phone use. But I can say that looking down at anything for long periods of time for reading, working on spreadsheets, writing, or a hobby isn’t good for the spine. Adding habitual use of these devices only pushes marginal cases over the top.


Before I give my patients a recommendation for surgery, I’ll want to exhaust all other treatment options. But let’s say that we’ve reached that point and the pain in your neck is not only chronic, but it is intensifying. Worse yet, you’re also exhibiting signs of neurological damage (tingling, numbness in extremities, weakness, motor loss).  This is a sign that degenerative disc disease is advanced enough that bone in the spine is pinching one of the many branches of nerve fiber that emanate from the spine. This is usually the cause of the chronic pain.


There are two major surgical options to correct this problem:


The first is spinal fusion surgery. I mention it first, but it is the least favored of my recommendations. This is brute force against back or neck pain and should be implemented when there are no other viable treatment options. As the name suggests, the procedure results in fusing two vertebral levels into one to stop bone movement where the pain is generated. The reason this procedure is the least of my recommendations is that it results in the reduction of movement – you’re literally left with less range of movement than you had before. Can you imagine such a result at any age?


My favored procedure when patient conditions necessitates surgery is artificial disc replacement (ADR). First approved in 2007 for the cervical region of the spine (2005 for lumbar applications), ADR is unlike fusion in many ways. Disc replacement attacks the problem by replacing the damaged disc with an artificial one. The procedure is far less invasive than fusion. As a result, the ADR patient preserves as much of their natural movement while eliminating the cause of the pain. And although ADR is newer than fusion, all current studies show that there is a superior statistical outcome for ADR patients.


However, I think went to avoid spinal surgery. And we can. We can change the way we use our phones without adding stress on our neck and back. Want to do your kids a favor? Lead by example and teach them how to use a phone the right way: Hold your smart phone up when texting, and use two hands (both thumbs) so that you’re in a more balanced and comfortable position for the spine. Whatever you do, don’t lay the device on your lap or keep it low. Bring it up to eye-level as much as possible, and that’ll relieve lots of stress right away.


I also recommend that you review your computer habits. Raise your monitors or laptops so that they’re at a neutral level to your eyes. If you’re going to be at a computer for extended periods of time, use a separate keyboard and keep it a few inches above your knees (this will help with elbow pain as well).


I tell my patients, “movement is life.” What I mean by that is that our level of mobility dictates our quality of life. I will do everything in my power to ensure that my patients retain all the movement that I can give them. But we can all do better to adopt habits that hold off becoming a surgical patient for as long as possible.


Get rid of “text neck.” Especially for the sake of our kids.



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