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Text Neck: Is the Epidemic Truly Over?

After scaring us that texting led to a neck pain epidemic, some media outlets are now reporting it was never a thing. Both extremes commit the same sin.

You may have seen the headlines recently: “Text Neck Was Never a Real Epidemic” and more along those lines. The idea that had been sold to us as an apocalyptic epidemic by the media—that looking down at our cell phone to text was responsible for chronic neck pain—was suddenly busted. We’re all going to be OK! Our necks will be fine!

Text neck was a chiropractor’s wet dream, of course, so much so that one of them founded the Text Neck Institute to cater to this emerging (or is it imaginary?) market. The Institute even has an app for that! If you own an Android cell phone, you can pay $3.01 to buy their Text Neck App that will make your phone vibrate when you hold it at an “unacceptable viewing angle”.

Our own CBC reported a year ago that “smartphone-related neck pain [was] on the increase”. And they quoted spine specialists! Now, the spokesman for the Chartered Society of Physiotherapy in the UK quips, “I doubt the ancient Greeks suffered from scroll neck.”

We see this see-saw movement in the media with regards to food: one day coffee is good for you, but the next it gives you a kind of cancer you didn’t even know existed. And this represents a failure by journalists to contextualize.

You see, scientific studies don’t appear in a vacuum; they are part of a growing body of evidence. To simply report on a single study like it’s a stone tablet handed down from up above is misleading and leads to knowledge whiplash (something a chiropractor may soon trademark).

Looking at the literature on the association between texting and neck pain, the answer is really muddled, because the studies that have been done on the topic are flawed.

Take this latest study, for example, the one that seemingly disproves the very notion of text neck. They asked young adults to come in, hold onto a cell phone, and text a certain sentence. The scientists took a picture of these participants to assess how much neck craning was going on, and they looked for associations with self-reported neck pain. They found no association.

The flaw is the following. The angle at which the participants were looking at their phone was not formally measured. Three clinical experts were asked to sort the pictures in one of four categories: appropriate posture, acceptable posture, inappropriate posture, and excessively inappropriate posture. You can already see that this subjective assessment is prone to bias and inaccuracy. Indeed, the scientists calculated the agreement between the three clinical experts, and it was not very good. So who knows how reliable these results really are?

On the flip side, studies that showed an association were sometimes done with participants who were not “scientifically clean”. What I mean by that is that they were recruited from clinics that specialize in neck pain or from offices where tasks require prolonged computer use. So was the neck pain caused by texting… or by computer use?

The body of evidence on this question is unclear at this point. Some studies are positive, others are negative. Overall, however, it doesn’t look like text neck is the epidemic it was called out to be. Better, more rigorous studies need to be done before we have a solid answer.

The lesson here is one we often repeat: “a new study” is meaningless unless the journalist puts it in its place. This latest study on text neck is not the nail in the coffin. Conclusions to a paper can’t be reported as is; they need to be critically assessed. And even then, contextualization is important.

As for those ancient Greeks who never got scroll neck, have you ever tried to read Ancient Greek on a dusty old manuscript?

It’s a real pain in the neck.


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