Have You Got Text Neck? Symptoms and Solutions

Two years.

That’s how long I’ve been in pain. I’m not talking about emotional or anxiety driven, soul-searching pain, which you might assume given the title of this article and the rising evidence of the impact of our phones on our mental health.

Nope.

I’m talking about actual, physical pain.

Symptoms of Text Neck

Pain in my back. Pain in my neck. Pain in my hand, my elbow, my arm. Pain enough to take pain medication almost every day for those two years.

“I think I injured it doing some DIY,” I told the first physiotherapist I met a couple of months after the pain started.

It was the beginning of 2016 and having torn my knee apart in every anatomical way possible, I’d been forced to return to the UK – quite the shock after nearly 6 years of being a full-time digital nomad. However, knee surgery awaited and functioning under the UK’s National Health Service, I knew I was in for a long wait.

Pushing aside my vast disappointment at no longer being on the road, I bought an apartment.

Maybe this was life’s way of aggressively informing me it was time to grow roots again.

And those roots I tried to hammer into the ground by flat-packing an entire apartment’s worth of furniture over the course of a week. It wasn’t such a good idea, my body told me as I acquired a hellish pain in my upper right back that spread all the way through my elbow and into my forearm.

The power drill did it! That poor device was given the blame for everything for the next 22 months.

I’ll rest my arm, I thought, my mind focused on readying my knee for ligament repair surgery. I didn’t have space or tolerance for a second injury, so I pushed my arm pain to the back of my mind. Except I couldn’t. That’s the thing with pain: it’s a big screaming alarm that only screams louder the less it’s heard.

“Probably RSI,” the first physio told me and my heart sank. As someone who earns her living online, typing and clicking, this was more devastating news than f&cking up my knee. At least with my knee I wasn’t losing my dream of a Premiership football career. Losing the ability to type when you’re a writer? Horrified is not an understatement.

Treating the symptoms of text neck

Of course, I headed online (more clicking, more typing) to garner further advice. I bought a bendy resistance bar and set about transforming my working life.

Over the course of the next 18 months I:

• replaced my 3 month old office chair with a smaller, more ergonomic office chair (it was a prettier colour too, but that was pure bonus)
• bought a wrist rest
• bought a back rest
• bought a foot rest
• bought a laptop stand to raise the height of my laptop on my desk
• bought a separate keyboard
• bought a trackpad and a stylus
• moved my office around (because I was convinced there was a 0.5% gradient where my desk had sat – my brother confirmed my suspicion but he was drinking wine at the time, so I’m no longer sure)
• invested in dictation software
• probably freaked my neighbours out with the use of my dictation software (thin walls)
• tried to yoga my pain away (knee permitting)
• and when that didn’t work, forced myself to work in 10 minute stints with 15 minute break in between. I don’t know if you’re aware, but the writing workflow just doesn’t work that way

Seeing as I’m mounting this list of evidence against myself, displaying the extent of my pain and desperation, I may as well confess that I also replaced my 6 month old mattress with one that was softer and contained memory foam, and I replaced my nearly new sofa, too (though there was a fault with the original one that meant I could at least do a free swap in that instance). [Note: in all cases, I sent the ‘old’ and discarded items to good charities where they could be reused.]

Perhaps your first reaction to this list is: wow, that must have been expensive. It was. But when you’re lying awake at 3 a.m. trying not to take pain medication for the chronic ache in your right hand side, it becomes one of those ‘I’d pay anything just to take the pain away’ kind of experiences. And ‘anything’ I paid. Over and over again.

In hindsight, writing this list, my own reaction is: how on earth did I not look down and question my iPhone? My RSI was one-sided. My right side, where I hold my phone. But that was also my mouse and clicking arm, so that got the blame.

Late September 2016, I had my ACL repaired and the hospital kindly gave me some lovely codeine. I didn’t need it much for my knee (that pain eased relatively quickly) but it worked a treat on my back and arm.

A few weeks after my knee surgery:

Me: “I’ve found that if I kind of click and move my back in this way,” I said, demonstrating to a friend, “the pain kind of goes away. For a few minutes, at least.”

Friend: “But how’s your knee?”

Me: “Oh, that? Healing nicely.”

By December 2016, with my knee recovery coming along, I was becoming increasingly concerned at the pain that I’d medically been ignoring. The last thing I wanted was a second weekly trip to physiotherapy sessions. My knee was occupying me enough. However, as I was side eyeing the remaining stack of codeine that was idling in my medicine bag (the medicine that had been prescribed because someone had used a scalpel on my knee), I knew time was fast approaching (in truth: had long passed) when I’d have to ask the doc.

But these things can’t be rushed, right?

When I get back from Asia, I told myself.

With a three month jaunt planned through South East Asia between January and March 2017, I thought I’d let the East do what, in the West, I’d tried and failed: to reset my body back to zero.

And, for the most part, it worked.

By the time I stepped off the plane at Heathrow, with three months in Asia under my belt, my body had all but fixed itself. I’d need some final physio for my knee but between regular massages, a yoga retreat and an extended break from my laptop, I felt like a new me.

Significantly, my iPhone had also managed to breathe it’s last breath while I was away and for the final 2 weeks of my trip my phone was as useful as a paperweight in a paperless world.

I missed the camera, my social media FOMO was pretty intense and I’d rather not talk about the 9 minute walk to meet a friend for lunch that turned into a 47 minute schlep thanks to taking a wrong turn and not having Google maps to hand, but I otherwise got by just fine without it.

Most probably I was fine because my phone detachment was novel and, vitally, temporary: getting a new iPhone was the first order of business when I landed back in the UK.

It’s important to note the difference in my iPhone addiction when I’m travelling versus when I’m at home. For the large part, I rely on wifi when I travel. Unless I’m in a country for more than a couple of weeks, I don’t tend to bother with a local SIM and, as wifi isn’t always available or is often so slow it’s useable, I’m routinely forced offline and off my phone.

More than that, I’m busy doing other things. Perhaps because I started travelling in the pre-smartphone era, when a hand sketched set of directions and a chat to the person next to you were as good as you’d get for maps and social, I have a certain sense of nostalgia about travelling that way. Sure, as social media has flooded our lives (and let’s not forget that I run a website where I eagerly try to garner traffic on the daily via such means), I’ve embraced it as much, perhaps more so, than most. Not, however, when I travel.

In a hotel lobby, museum, restaurant or airport packed with people staring down, I like to try my best to be the person looking up. Surrounded by new surroundings, I want to experience them, absorb them and truly take them in. No matter how likeworthy an ex-colleague’s new curtains are, what’s going on under my nose in a new country is hands-down (phone-down) going to be more interesting. Even if it’s as mundane as Italian pigeons fighting like gladiators over the crumbs in a crisp packet. Why? Because it’s happening for real, in front of me, in this moment, right now.

Yet, all that sentiment and sense of living-in-the-moment righteousness flies out the window the second I fly home.

Hell knows why. A lifetime of habit or just plain familiarity?

Sat on the Tube after my flight back from Asia, absent an iPhone to play on (“must get to the Apple store, must get to the Apple store,”), I look up and I’m confronted with the sight of everyone looking down. Prone to a good dose of comedy and accepting that it will be at least 12-hours and a night out with friends before I can buy a new device, I rip a sheet of paper out of my notebook and ‘make’ myself a phone.

Tri-folded, my paper has a home screen, a social media screen (fit for fake swiping and liking), and a page for games because who isn’t addicted to static Candy Crush. (Plus, I’ll have something to colour in when my friends are all on their phones in the pub later.) They’re strangers and they’re on the Tube so I don’t expect anything like an audience as I amuse myself with dramatic flicks and taps on my fake phone. What surprises me the most is that nobody even raises an eye from their not fake phone to notice. I could have sat there wearing nothing more than a snake as a necklace and I still wouldn’t have drawn a stray eye away from an engaging phone.

It’s 2018 and this is a sign of our modern times.

“My arm and back are fixed,” I declare to all my family and friends. “Asia,” I say because that’s surely explanation enough.

The problem is, Asia is no match for the self-debilitating transaction I’ve just made. In the Apple store, at nearly £1,000, I have purchased a newer, shinier, faster and – vitally – bigger iPhone that isn’t going to just put me back where my pain started, it’s going to let my pain level up. To excruciating.

If only I hand’t consigned my paper ‘iPhone’ to a drawer.

Within a week, I’m back on my daily medication, trying my level best to restrict it to nighttime only.

Within two weeks, I’m setting about replacing half my furniture – I didn’t sleep on this mattress while I was away, surely it was that? I spend a week on an inflatable bed in my office (avoiding the 0.5% gradient slope) just to see if it is the mattress. I can’t really tell but I’m in so much pain that buying a new mattress has got to be worth a try. The sofa is next for the chopping block.

Within a month, my work hours are reduced to nothing you’d call useful. Instead, I lie on my side, mournful, swiping through a loop of social media, still not having the brains to connect why the pain will not stop.

I’d like to say at this point that I am, otherwise, most of the time (apart from when it comes to catching – and missing – flights), a fairly bright person. I even have a certificate from law school to prove it. Yet, I still wasn’t able to link the dots. My brief physio sessions had said RSI and I’d automatically associated that with upright sitting, typing away at a desk. Or working in a supermarket or on a conveyor belt in a factory, but neither of those applied. You didn’t get RSI from lying prone checking Instagram. Did you?

(Spoiler: you can absolutely get pain from too much phone use. Text neck and mobile elbow are new phone-induced ailments that are on the rise. More information below in case you’re suffering.)

This level of ignorance and iPhone blindness continued for another year.

Yes. A year.

Over the summer, still in pain, I flew to Mexico. It was a trip that was cut short by my mum getting ICU level sick and I flew back in a panic. While my pain had subsided during my brief time in Mexico, it came back with a vengeance upon my return as I spent most of my time face down in my phone updating relatives on my mum’s health. I’m very pleased to say that my mum has recovered. My pain didn’t go away quite so quickly.

“You should go and see someone. Properly, this time,” a friend told me.

I knew it was the right thing to do but between my knee surgery, related physio and then months of visiting my mum in hospital, I was fresh out of any urge to put myself in the path of the medical profession, especially when it was the devil’s work to try and get an NHS appointment. However, things had gotten so bad that the pain was interrupting my sleep and, as you can probably guess, I filled those empty middle-of-the-night hours, swiping on my phone.

I’ll ‘go private’ one last time, I thought, this time booking in to see a chiropractor. Try to keep in mind the law school certificate proving my smarts when I tell you that I found my chiropractor online and my basis for selecting him was the fact he was equidistant between the hospital (where I was visiting my mum daily) and my home. Tipping the balance was the presence of one of the oldest bakeries in the city opposite his office. For all the wrong reasons, I was sold.

“You need to stand up tall as though you’re a lion waiting to pounce,” he told me.

I squinted. Then frowned. I’d been to Africa and I’d seen lion’s in the wild and if there was one thing I knew for sure – lion’s don’t stand up to pounce. Nevertheless, I let this man charge me £40 for a 45 minute session that quickly progressed to him ‘having a go’ at acupuncture.

Having heard family and friends (and the Internet: tap, tap, swipe, scroll, swipe) wax lyrical about the healing and restorative effects of acupuncture for myriad ailments, I didn’t miss a beat before saying yes.

Life advice: if someone suggests they ‘have a go’ at putting pins in you, say no and, if at all possible: run.

“I think I hit something, didn’t I,” were his exact words but I didn’t need him to tell me that. I could see the nerves twitching in my hand. Oh, and there was the whole white hot pain thing, too. Pull the f!cking pin out was all I could think as he looked at my pulsating skin with what seemed like mild amusement.

“Can you take it out, please” I eventually asked, British politeness prevailing. He obliged. I never saw him again.

I did, however, give acupuncture another try. This time with a Chinese herbalist who came on recommendation.

“Lie down,” she said with complete confidence despite the fact I had pins stuck in both my front and my back.

“On which side?” I asked, as she answered by easing me backwards. Perhaps I’m too queasy but trying to fall asleep, as instructed, is not an easy feat when you’re highly aware of the fact that you’re lying with a dozen pins in your back. Still, I trusted this lady enough to try cupping as an added measure.

It was a fascinating experiment that allowed to me try out ‘what I would look like as a ladybird’.

At the end of the day, none of it worked and, eventually, to the NHS I returned.

“It’s really common these days,” my new physiotherapist told me after a thorough questionnaire that left me feeling beyond foolish at letting my pain rumble on for so long. It was chronic at this point, he advised me, having gone untreated for as long as it had. It would likely take months to resolve, he advised. But he was confident I could be fixed. They were magical words and not for the first time in my life, I was reminded that not all heroes wear capes.

“It’s your posture – your head is tilting forwards, putting pressure on your spine which is causing pain in your neck, back and arm. Laptop. Mobile phone. I see kids as young as 13 suffering from the same condition.”

Mobile phone.

He’d said it as plain as day, but still: I. Had. Not. Heard.

“I’ve fixed the way I work. I try to limit my time online. I’m using dictation. I take breaks between typing,” I said but I was only ever referring to my laptop. I wasn’t talking about the phone that I’d checked umpteen times while I’d sat in the waiting room, happily scrolling until my name was called. The phone I’d pick up within seconds of leaving his care.

He gave me a series of exercises and for the next three months I practised them religiously, three exercises in total, four times a day. Five is I was having a big pain day.

“It doesn’t feel any different,” I said in each subsequent session whilst emphatically explaining all the steps I’d taken to reduce my (laptop) screen time. Of course, I never used the word laptop so how would he know that my phone use was as prolific as ever.

“Just keep trying,” he said, assuring me that eventually my posture would correct. But what more could I do, I wondered? I was already balancing on a gym ball at my desk, the second office chair long having wheeled itself to the charity shop.

“I. Am. Stupid,” I may well have said as I left each session, picked up my phone, lowered my head to the exact damaging tilt he’d just talked about and scrolled all the way home.

Then, last month in Kruger National Park, 22 months after first looking at the power drill in disgust for all the pain it had caused me, it finally hit me. (‘It’ being realisation, not the drill, obviously).

I really, really, really can’t claim to be any kind of Archimedes given how long it had taken me to connect the device in my hand to the pain in my arm, back and neck, but sitting in my treehouse, entirely disconnected from the Internet (and therefore my iPhone), I finally had a Eureka moment. My pain had slowly ebbed away, as it always did when I travelled. However, instead of attributing it to the change in mattress or workspace or work hours, I finally saw the one change I made every time.

I used my phone a whole lot less.

Could that be it?

My pain had intensified after I came back from Asia…the exact same time I’d upgraded phone size.

In fact, hadn’t this all started when I returned to the UK from my travels? Hadn’t it started when my Internet connection became solid and I started to fill my quiet nights catching up with friends online, from the comfort of my sofa or while lying on my (nothing wrong with it) mattress? I wasn’t able to get out much courtesy of my knee operation so my phone use had ramped up considerably.

Curious, I conducted a small test.

How to reduce your phone use

I’d go phone free, or as close as I could manage, for a month. It would be hard but I’d invested way more time with much more convoluted methods trying to get pain free until now. (Yes, I’d experimented with tipping myself upside down thrice daily to see if it made any difference to my back. It didn’t.) It had to be worth a shot (and not of the cortisol kind I’d been avoiding).

Within 48 hours I noticed a difference. That quickly. Combined with the physio program to right my posture, my arm pain all but melted away.

Could it be that really simple?

The answer came the second I returned to Johannesburg, reconnected to wifi and instantly reignited the pain.

Maybe it could be.

For the next few weeks, I reduced my phone use dramatically and my health flourished in response.

A few weeks forward and not only has my arm pain reduced to a bare niggle, my posture has started to right itself too. I still do my exercises daily and I’m not yet a standing lion ready to pounce (will I ever be?) but my shoulders are no longer curving forward and my neck is better aligned.

I’ve typed this entire article in one sitting (on my gym ball – I wish I’d kept my office chair) and without taking a single pill to ease myself from pain.

Unexpectedly, there have been other significant positive side-effects, the most notable of which has been my sleep. My entire adult life I’ve consigned myself to the ‘night owl who doesn’t really sleep well’ category. Being a lawyer and mainlining coffee were my original excuses but they walked out the door the day I did. Still, my sleeplessness continued…until I gave up my phone. Without the glare of blue screen sending ‘stay awake’ messages to my brain, I’m sleeping earlier and easier. I’m waking rested, too.

So astonished by this unexpected consequence, I recently read Arianna Huffington’s book ‘Sleep Revolution’ and spent the entire time nodding in agreement at all the scientifically proven ways using technology is bad for your sleep…and how not getting enough sleep is bad for your body.

I still have a long way to go, breaking up with my phone. The temptation of constant wifi is hard to resist and despite my best efforts, I recorded (with my newly installed Moment tracking app) over 2 hours of phone use yesterday and it’s likely to be more today. It was 2 hours by mid-day (ouch, literally).

(Install the app, I guarantee that you use your phone twice as much as you think you do.)

Detaching from my phone and social media in particular, has been difficult. These things are designed to be addictive, after all. However, when the alternative (using my phone) comes with a good dose of pain, it’s a pretty impressive motivator and persistent reminder.

I’m not about to declare that Facebook and I are are over and that Instagram is no longer in my vocabulary – I run a website where I promote travel on these platforms. But I can reserve my use for work, conducted via my laptop at my workspace, which has adjusted to within an ergonomic inch of its life, with perhaps a bit of ‘social’ social thrown in from time to time.

In the meantime, I’m setting about the business of looking up. Instead of returning from my recent trip and slumping into a fit of fatigue, my iPhone keeping me company as I moped about the weather, I got up and got out. I visited family, I caught up with friends. You know, IRL, like we used to when MySpace was a fad that didn’t keep you from enjoying your actual, breathable space. As well as being pain free, it’s been equally rewarding and liberating, living life without the crutch of a screen.

I don’t know what has shocked me most during this journey. The impact that a hand-sized, hand-held device can have on your health (pain, sleep and the more emotional downsides that science has proven). Or my complete blindness to the impact my phone was having.

Actually, I do know what has shocked me most. It’s the words that are still floating round my brain like ghosts; the words I heard all those months ago, when I was still in denial, blaming my workspace and every other useable item in my life besides my iPhone (sorry, drill):

“I see kids as young as 13 suffering from the same condition.”

Thirteen.

One decade.

Three years.

These children don’t have the ability to take a solo trip to Kruger to learn that their phone addiction is causing them chronic pain. And I suspect these kids would hunt down wifi anyway (perhaps in the manner of a lion standing ready to pounce).

Want to hear something even worse? “[…] it’s not an exaggeration to describe iGen as being on the brink of the worst mental health crisis in decades.”

These are words I read in “How to Break up with Your Phone“, a book I’ve been reading with fascination since I’ve started down this rabbit hole of how bad our devices are for our health. (Also, because, you know, Facebook is addictive and all addicts need some help when trying to quit).

If you’re reading this, probably on your phone, I hope it gives you a second’s pause. If you have children, particularly over the age of 13, I hope you take more than a few seconds. And if you have children under 13, perhaps you’re in the best position to act.

I’m not saying quit your phone entirely. I have no plans to do that. There are still plenty of uses for my phone I don’t want to quit (e.g. I’m still trying to beat the 33k daily steps I recorded on my iPhone that time I spent 26 million hours walking around Athens). And wrestling it from teenagers when there is a generation-wide epidemic and peer-pressure to boot is a challenge I wouldn’t like to take on. For that: Godspeed.

What I am saying is look after your health. It took me two years of actual, physical pain to realise I needed to drastically reduce the addiction I, like most people, have with my phone. Maybe you don’t have pain or any of the sleep or mental health related issues that our phones are causing. Yet. Maybe you never will. But it’s best to be aware.

As Jim Rohn (rhymes with phone?) once said: “Take care of your body. It’s the only place you have to live.’

More information about text neck and phone health

The pain I experienced has a modern name: text neck. You can find out more about it on the NHS website here.

There is even something called mobile phone elbow or cell elbow, another list of symptoms I can relate to. I can’t find a medical source I’m familiar with and trust so do your own checking but you can find out more here.

What you can do if you think you have text neck or mobile elbow:

• first priority: put your phone down and see if it gets better
• see a doctor and get a diagnosis. Don’t put it off.
• do the exercises your physiotherapist gives you
• install a time tracking app to see how much time you spend online
• work to reduce this time spent on your phone (How to Break Up With Your Phone is a great place to start)

The idea of saying goodbye to countless hours on your phone may be horrifying but there’s a whole world out there ready to explore. You’ll find plenty of inspiration here.

Has phone use had an impact on your health? Have you suffered from text neck or mobile elbow or some other phone related pain? What about your sleep or your mental health? Do share your experience in the comments below. It’s a topic that we don’t seem to talk about enough (maybe because it’s hard to Instagram pain). Tips for parting with your phone are welcome too.

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