How Smartphones and Tablets Are Affecting Your Spine

Whether you call it “Text Neck” or “Tech Neck”, most of you reading this have probably endured at least some form of neck or back pain, headache, or even jaw pain. It may have not been obvious at the time of experiencing your symptoms, but the use of your smartphone or tablets are one of the main causes of your symptoms. And over time, guess what can happen… even your posture, or the way you hold yourself up, can change! Sadly, these changes are occurring earlier in life for our younger generations. Without a doubt, children these days are using these pieces of technology way more than our older generations have or ever will, especially since kids use these for school and for play. It is time we start to educate everyone on how these, handy, yet debilitating devices are affecting our spine and ultimately our entire health and wellness. What is happening when we use a smartphone or tablet? We use these items for communication, research, scheduling, navigation, ordering food to be delivered, online shopping etc. Reliance has grown tremendously, even in the last 10 years. In the United Kingdom, the average amount of time spent on the phone in 2019 was 3 hours and 23 minutes. This number increased in the 16-24 year old groups to 4 hours a day. And in the United States, the average American spends 5.4 hours a day on their phone. Again, that millennial group was found to spend slightly more time on their phones, 5.7 hours. Remember, these are averages, some people are on their phones for 12+ hours! No matter what age we are, when we use these devices we put our spine into a poor position. Think about yourself as you use your smartphone or tablet. What sort of positions do you find yourself in? Perhaps some of these ring a bell:

Bending of your neck so that you can lower your eyes to look at the device.
- Over stretching and weakness begins to occur throughout all of the muscles meant to support the spine. To try to help add some stability, as your neck is bent forwards you may then slightly extend your head up. This is called forward head posture and is one of the main causes of headaches!

Forward head posture

Excessive round of your shoulders, especially the one holding the device.
- You need to be able to hold the smartphone or tablet in front of you, therefore you can’t help but to round your shoulder forwards (unless you knew the importance of posture!). And the rounding worsens the more that your neck is bent forwards.

Excessive rounding of your thoracic spine.
- Your neck and your thoracic spine (aka your mid back) are so connected. As you continue to keep your neck bent and your head forwards, the rest of your spine continues to round with it. It can get back enough until one day you cannot sit up tall anymore. Can you imagine what this does to your organs, especially your ability to take a nice, full, deep breath of air?

Mid-back rounding

Guess what? That rounding goes all the way down to your lumbar spine (aka your low back).
- Your pelvis, or you can think of it as your tailbone, will even start to tuck underneath of you, turning off your powerful hip muscles and tightening the muscles in the front of your hips. Check out this post on upper and lower cross syndrome!

And, most likely, if you are holding the device in one hand, you are probably side bent through your whole back to that one side. Whether this is because you are leaning over to support that arm on a table or armrest while you use your phone or just out of pure weakness and inability to hold yourself up, it can wreak havoc on your body. Now, these points are just a general overview, but these are also the most common postural deviations noted with use of these smart devices. Can you see yourself in any of these positions while you use them? A recent study on college students found that all of these postural impairments do occur. (Honestly, all of us can see these effects on people using smart devices if we know what we are looking for). This article demonstrated:

Rounding of the shoulders
Thoracic Spine kyphosis (increase in the curve, or rounding)
Neck bend, not only forwards, but also to the side
Pelvic obliquity (the pelvis is out of alignment)

All of these postural imbalances can result in long term pain, impairments, and decreased ability to concentrate.¹ Let’s look a little more at the consequences the use of these devices have on our health and wellness. Consequences on our health and wellness We will start back up at the neck. Studies have shown that the increase in flexion, or bending of our neck, causes changes in the natural curve of our spine. A healthy back has three natural curves: a slight forward curve in the neck called a cervical curve, a slight backward curve in the upper back called the thoracic curve, and a slight forward curve in the low back called the lumbar curve. You know by now can be destroyed by poor posture associated with use of these devices. As our posture changes, there is an increase in stress through the spine of our neck as the natural curve cannot attenuate the weight of the head and gravity, as well as the ground reaction force, whether we are sitting or standing. Besides the joints of the spine enduring more stress, the surrounding ligaments and muscles obtain more stress and can start to spasm. There is actually another fun fact about our neck, it has so many receptors that provide our brains information on where we are in space, how our head is aligned with the rest of the body, and what it needs to do to keep the eyes level. Honestly, our body’s number one goal is to keep our eyes level and it will do whatever else it needs to do to the spine in order to achieve this goal. But with the increase in stress, spasms, and as mentioned above, the overstretching and weakness that happens to the spine, the receptors don’t work as well. You can imagine the potential visual and balance problems, headaches, and eye strain that can occur.² Let’s move down to the thoracic spine. This area of our spine, our mid back, also includes our ribs as our ribs attach onto our spine! Try taking a deep breath. You probably feel your ribs expanding (if not, you may want to work with a Physical Therapist on this). Now, bend forwards, such as when you are using a smart device, and try to take another deep breath. You just physically cannot! You are stopping your ribs from expanding by rounding your mid back and “squishing” your rib cage, which also presses on your organs, decreasing your diaphragm function, and inhibits your lungs from fully filling with air.³ And as we move down to the low back, remember, all of the rounding that happens above, continues to work its way down. Whether you are sitting or standing, your pelvis will then start to tilt, or tuck, underneath of you, decreasing your ability to use all of your muscles of your core and hips appropriately. While these devices have gained popularity in the last decade, the problems associated with them have not. There could also be health implications that we are not aware of due to the fact that these devices are still relatively new. How can we improve our chances? If everyone could understand the importance of posture, we may all be in a better position, figuratively and literally. It is possible to improve posture while using a device. Simply knowing what posture to sit or stand in and then knowing the correct stretching and strengthening exercises to do can be very beneficial. (This is for another article at another time.) But for immediate assistance you can purchase some accessories or implement some features that can make your ability to use your smartphone or tablet a lot easier while also improving the health of your spine.

Tablet holder, whether this is used on your lap or on a desk, it can decrease how much you have to bend your neck and head down.
Use hand free features, such as talk to text and text to speech features.
- Talk to text allows you to talk to your phone while it types what you are saying which is helpful for texts, emails, and even for search engines.
- Text to speech is a feature that allows your device to read whatever it is that is on the screen out loud to you.
Active sitting chairs, such as the Symbiotic chair.
- This type of chair allows you to sit comfortably with the freedom to use your own muscles to move your spine around to more natural and healthy positions.
Alternate what hand is typing or scrolling on the device.
Take frequent breaks!

These smartphones and tablets allow us to do so much. They have been life changing in this pandemic as they have the ability to connect people across the globe. They provide instant information to our pressing questions about the world. And they can occupy us when we need a distraction from what is going on around us. But we need to make changes now so that we can avoid the long term pain and disability that can arise, especially in our spine, and so that we can continue to use these amazing and advanced devices throughout the course of the rest of our lives.

Author: Adria Biasi, US based Doctor of Physical Therapy and Board Certified Orthopedic Specialist

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How Smartphones and Tablets Are Affecting Your Spine

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