Influence of neck pain on cervical movement during smartphone use

The use of smartphones has dramatically increased over recent years for activities such as sending and receiving email, accessing the internet and engaging in entertainment (Perera 2012). There has been emerging evidence that a correlation exists between duration and frequency of use of a smartphone and neck pain (Berolo et al, 2011).Smart phone pic


A recent study by Kim (2015) examined changes in the posture of young adults with and without mild neck pain (MNP) when using a smartphone. The author recruited a small number of students who had used a smartphone for at least 12 months. Subjects with a significant history of neck trauma, radiculopathy and fibromyalgia were excluded from the study. Subjects in the MNP group had elevated measures of Neck Disability Index (NDI). Measures of upper cervical (UC) and lower cervical (LC) positioning in the sagittal plane were measured using an ultrasound-based motion analysis system while the seated subjects used a smartphone.


The author found that during smartphone use, the group with mild neck pain (MNP) exhibited greater UC and LC flexion angles than the control group. Greater flexion angles had the subject positioned further away from a neutral head position. These flexion angles were also shown to increased with sustained positioning. Kim concluded that these findings indicate that young adults with MNP experience difficulty in maintaining a neutral neck posture during smartphone use.


While it is not possible to draw a causal relationship from the study, the relationship between the presence of mild neck pain and increased flexion during smartphone use may indicate that the poor positioning contributes to the onset of the neck pain or that altered motor control of the neck muscles due to pain results in an inability to maintain a more neutral cervical positioning.


Kim concludes that that young adults with MNP should be more aware of cervical positioning with sustained and frequent use of a smartphone. Further research into optimal positioning and recommended time for smartphone use is planned.


Workplace Physiotherapy incorporates guidelines for use of smartphones and tablets in their Injury Presentation and Manual Task Training programs for employers and provides recommendations to individuals during treatment intervention.



Ref: Berolo S, Wells RP, Amick BC 3rd: Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: a preliminary study in a Canadian university population. Appl Ergon, 2011, 42: 371–378.
Kim MS: Influence of neck pain on cervical movement in the sagittal plane during smartphone use, Journ Phys Ther Sci 2015 27: 15-17
Perera C: The evolution of E-Health—mobile technology and mHealth. JMTM, 2012, 1: 1–2.


The comments above are the implicit advice of Workplace Physiotherapy. The views expressed are based on current evidence-based research and accepted best practice approaches. Unless otherwise stated, these comments are not the view of WorkCover NSW or any other professional body. No reproduction or forwarding of this advice is permitted without the consent of the author.


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