Smartphone overuse is a hotly debated topic in our household. My wife and I are complete technophobes (we both sport iphone 7’s and our ipads are 9 years old). Our kids don’t even know how to unlock our devices let alone use them. Yet we still hate how much we are on our phones.

You have likely seen ‘click bait’ style headlines about the dangers of ‘text neck’ (here is one of my personal favourites). Most people also fail to see the irony that they are reading those headlines on their smartphone.

To be absolutely truthful, the science behind ‘text neck’ is not that great. Essentially it has been shown that the further forward you move your head from your spine, and the more you look down, the greater the forces on your neck. Yet this position has not necessarily been linked to increased pain.

Sexy headlines, but not exactly groundbreaking.

We have been expecting a paper to come looking directly at the association between smartphone use and the prevalence of neck pain. This would be one that we could hang our proverbial hat on and use as guidance when we suggest to patients to try and lower their overall phone use to combat neck pain.

That paper finally came out recently in the prestigious European Spine Journal.

This study took 1602 office workers (mean age 42) that had at least 4 years of prolonged smartphone use. The workers were assessed for smartphone overuse (SO) using something called the Smartphone Addiction Scale (SAS-SV).

Let’s pause for a moment to acknowledge that phone overuse has become so endemic that there is a statistically validated scale to evaluate addiction. Crazy.

The workers were also assessed for amount of physical activity they habitually performed as well as scales for depression, anxiety and stress.

There were a lot of alarming findings from this study. Here are some highlights:

• The prevalence of significant neck pain among all office workers was 30.1% (That’s REALLY high!)
• The prevalence of smartphone overuse was 20.3% in office workers.
• Office workers with SO showed a SIGNIFICANTLY HIGHER prevalence of neck pain (62.9% versus 21.8% for those without SO).
• Significantly more females had neck pain compared to males, but SO was more prevalent in males and in younger people. Higher education also predicted SO.
• Single office workers had 1.6 times greater chance for SO versus married co-workers. Not a huge surprise.
• Workers with severe depression, anxiety or stress showed a higher prevalence of SO.
• 6% of office workers had severe depression, 31.3% severe anxiety and 36.6% severe stress. All 3 of these were significantly related to neck pain occurrence (up to 90% more likely!)

We know research only grabs headlines with a ‘sexy finding’. The authors performed something called a regression analysis to establish the association between neck pain and smartphone overuse. Essentially you plug in a bunch of variables to try and tease out the actual relationship. The variables they used included education, gender, depression and physical activity.

The finding was fairly stunning:

Smartphone overuse has a 6 times greater chance of developing neck pain!

Now that’s a message we can tell our patients!

But wait! There was yet another important finding.

We now know the bad stuff associated with smartphone overuse – depression, anxiety, stress, age, level of education and 6 times higher likelihood of neck pain.

But what about the other side of the coin? What is associated with LESS neck pain? Well the paper did discuss this, but they really made you work for it! One sentence in the results section and one sentence in the discussion section were as important as the rest of the paper combined.

The first sentence said that the more a person was physically active, the less they had observed neck pain. The second showed that of those who partake in vigorous activity just 7% developed neck pain. Of those that participate in light activity, 31.5% develop neck pain.

That’s REALLY important! Those who exercise vigorously had about a 4.5 times lower prevalence of neck pain.

It’s funny how we interpret research articles these days, and how the media filters their findings. 7 pages outlining all the causes and associations of neck pain. Then two sentences (one each in 2 different sections) outlining a variable that greatly LESSENS your chances of developing neck pain.

Guess only one grabs headlines.