Association between 'text neck' and neck pain in adults: a cross-sectional study

Abstract

Introduction: The neck pain (NP) is the fourth leading cause of disability in the world and is a potential public health disorder. With the increasing use of smartphones, new postural habits have been acquired during the use of these devices, and some authors suggest that text neck is the main cause of NP. However, this association was not found in the first cross-sectional observational study with a restricted sample and age group conducted in Brazil. Therefore, studies with larger samples with longitudinal design and participants with a broader age range from 18 to 65 years are necessary. Objective: To analyze the association between text neck and NP in adults. Methods: This is a cross-sectional, part-longitudinal study of 582 adults with a self-report questionnaire with sociodemographic, anthropometric, lifestyle, psychosocial, and cervical pain and smartphone-related questions. The text neck was assessed by recording two subsequent photographs of the research subject's posture, standing and sitting, with the Cervical Range of Motion (CROM) device to assess cervical angulation while typing a text on his or her smartphone. Logistic regression models were analyzed to investigate the association between the text neck - assessed through the cervical flexion angle - during text entry for smartphone messaging and the complaints and frequency of cervical pain outcomes. Potential confounding factors with a p <0.2 in univariate analysis were also included in logistic regression models. Results: Multiple logistic regression analysis showed that the cervical flexion angle with the participant standing using the smartphone was not associated with cervical pain (OR = 1.00; 95% CI from 0.98 to 1.02; p = 0.66), as well as not associated with the frequency of cervical pain (OR = 1.01; 95% CI from 1.00 to 1.03; p = 0.056). The cervical flexion angle with the participant sitting using the smartphone was also not associated with cervical pain (OR = 0.99; 95% CI 0.98 to 1.01; p = 0.93), nor was it associated. cervical pain frequency (OR = 1.01; 95% CI 0.99 to 1.02; p = 0.13). Conclusion: Text neck was not associated as much with the complaint of cervical pain as with the frequency of cervical pain in adults.