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All Things Posture - Spinal Pain and 'Text Neck'

The neck is a very important structure and it strikes a fine balance between stability (protecting our spine) and movement (we need to see and eat!). Neck pain is the 5th biggest musculoskeletal injury contributor to disability burden worldwide [4].

Posture is commonly labelled a major contributor to neck pain and other spinal pain, but this can be more harmful than helpful.

Let’s explain: if I asked you to stand in the same posture for 10 hours, something would eventually start to hurt, even if your posture was ‘perfect’. So sometimes focussing on maintaining "perfect posture at all times" is just saying “stand like a statue for the next hour”, which is not very helpful.

So let’s consider two questions:

  • What can I do to prevent developing spinal pain due to long hours of sitting (or any prolonged posture)?

  • What can I do if I already have pain and a certain position or posture is making it worse?

Well… The answers are the same!

1. Don’t be scared of posture

We’ve all had a friend who has THE WORST posture but doesn’t have back pain and there are certainly plenty of people with great posture who suffer from back or neck pain. So unfair! But also very reassuring. We don’t have to be perfect to not have pain, and if you do have “good” posture and still have pain don’t feel stressed.

The evidence agrees and is, at best, mixed to suggest that posture is a contributor to spinal pain. More often in research, there is no or weak relation between spinal pain and posture [12, 13]. So whilst there are people where posture is a major contributor, it’s much less than you might think.

There is also no case where fear and anxiety has helped anyone dealing with pain (or really anything). More often than not, these fearful beliefs can have a detrimental effect on people with spinal pain [1, 3].

A new controversial discussion, that’s relevant to everyone, is mobile phone use and its association with neck pain. Several high-quality studies do suggest increased mobile phone usage and increased head angle increase the risk of neck pain and longer instances of neck pain [2, 9, 11, 15]. On the flip side, some studies suggest there is no association [5][6]. So we end up in the same place we might find ourselves when considering posture and other spinal pain: there’s no clear answer.

Let’s simplify the problem: isn’t ‘Text Neck’ just another instance of having to stay in the same position for ages?

Yes. Yes, it is. How we would manage ‘Text Neck’ is the same as how we would manage anyone who struggles with prolonged postures. Firstly don’t be scared of your posture. Secondly…

2. Change posture frequently

Think back to a time you were sitting in a long, boring meeting or you finished watching a 3-hour movie… what was the first thing you wanted to do when it finished? MOVE. Get up, walk around, crack your back, yawn and stretch out. In fact, you probably already had been wriggling and moving the whole time. That’s what we want, posture ADHD.

What’s great about this analogy is it’s nearly perfectly reflected in the evidence! It’s also much more relaxed and easy to achieve compared to the militant “back straight, shoulders back, bottom tucked” for 24 hours a day. It’s also simple to apply to using our phones: swap hands, rest your arm on something, slouch, hold the phone higher or lower, sit, lay down and roll around. If it gets uncomfortable just change again.

To note from the evidence is when there was an association between neck pain and mobile phone use, there was an increase in the risk of neck pain with more SITTING mobile phone use [8]. This is attributed to increased head angle and is supported biomechanically [7,14]. SO, we can pretty simply fix this: DONT SIT… just kidding. But when you do sit, or even stand, consider holding your phone higher or resting your elbows on a surface to help you keep it higher to reduce your head angle.

3. Stay active and exercise

These can be general exercises or specific exercises. Most forms of exercise will involve your head moving or holding your head against gravity in different positions. Having this functional neck strength will be very protective. Finding a physical activity that you enjoy or what you can do consistently is always the priority.

If you want to level up your neck, check out specific exercises for breaking up sitting from our awesome blog post on Office Worker Neck, or our Instagram posts on general strengthening for the neck!

4. Modify your usage

Ok so if you’ve tried everything else, or you just want to have all your ducks lined up in a row, changing how much you use your phone can be a great strategy. A good way to tell is to try: see if a no-phone day (or even a few hours) helps your neck pain. We aren’t saying don’t use your phone, but we have some suggestions:

  • Listen more, find podcasts you like so you don’t have to look down as much. Set up that perfect Spotify playlist.

  • Reserve watching for larger, higher screens like your computer or TV.

  • Try not to use your phone while sitting, or have a rule to only use your phone when you can rest your arms on a desk or table.

We hope this helps, and if you need any more tips or tricks feel free to reach out or come and see us!

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