Is Your Phone Giving You Tech Neck? with Dr. Andrew Chan

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 Welcome to Health Matters, your weekly dose of health and wellness from NewYork-Presbyterian.

I’m Faith Salie.

In today’s digital age, many of us spend hours on screens, whether it’s scrolling on our phones or typing on our laptops. This prolonged use of devices has led to a modern epidemic of a condition known as Tech Neck.

This week, Dr. Andrew Chan, a neurosurgeon with Och Spine at NewYork-Presbyterian and Columbia, sat down with me to share ways to prevent and improve the pain and stiffness associated with Tech Neck — as well as general guidance to keep our spines healthy as we age.

Dr. Andrew Chan, thank you so much for joining us today on Health Matters.

Dr. Chan: Thank you for having me.

Faith: Can you please explain what Tech Neck is and why I’ve even heard it referred to as an epidemic?

Dr. Chan: Well, that’s exactly right. And broadly, what Tech Neck is, is it’s a problem that’s associated with the use of modern technology. So that’s why you’re probably hearing that it’s an epidemic, because now we’re surrounded by computers, phones, tablets, right?

And the issue becomes, when we’re using these devices, we look down at an angle. And when you’re doing that, you’re using what we call the extensor muscles of the neck or the muscles of the back of your neck more, and they have to work harder, and to give you a concept of how much harder they’re working, if your head is straight up, your extensor muscles are basically lifting about 10 to 12 pounds.

But if you look down just 45 degrees, which is pretty common, you know, let’s say you’re sitting on the ground and you’re working on your laptop. Then what’s happening is you’re actually now using those muscles to support approximately 50 pounds of weight.

Faith: What? Five zero?

Dr. Chan: Five zero. So it’s nearly five times as much. So you don’t need to use much imagination to then realize that doing that for long periods of time are going to lead to fatigue of those muscles at the back of your neck and then ultimately lead to the symptoms of Tech Neck.

Faith: I’m shocked that we’re all not walking around with Tech Neck. Isn’t that also the degree at which most of us look at our phones?

Dr. Chan: That’s exactly right. If you’re saying, you know, let’s say you’re sitting on a couch and you’re looking at your phone, it’s gonna take a lot of arm strength to keep it at the eye level. So most of the time people are looking down at their phone.

Faith: Okay, so what are the main symptoms of Tech Neck?

Dr. Chan: Yeah, so basically, if you spend a lot of time looking down, and you spend a lot of time in a single static position, and you start having a lot of neck pain, pain in your shoulder blades, a headache, spasms in your neck, stiffness in your neck, you probably have some form of Tech Neck.

Faith: Headache. Would it be located at the base of your skull?

Dr. Chan: There’s the attachment of the extensor muscles, some of them attach basically to the bottom of your skull. Anywhere where that muscle is located could cause pain, so you could perceive that in different areas, so a lot of people would perceive that at the base of their skull or the back of their head, but I’ve had patients even have, you know, pain even higher on their head. So, anytime you’re using a lot of your muscles, it could cause pain in that general vicinity.

Faith: Is it possible to suffer from Tech Neck and not feel acute symptoms?

Dr. Chan: I’m glad you brought that up, because they’re always talking about, what does that feel like for me today? But really what this does is this starts a cascade where you have excess stress on those muscles, the muscles get fatigued, and guess what now takes up the mantle of supporting your neck? It’s those joints in your neck, it’s the discs in your neck, and what ends up happening is then when those discs wear down, they can make you prone to things like disc herniations, joint arthritis, and these are the sorts of things that can pinch nerves.

And then so those are the things that then maybe you don’t have the initial Tech Neck symptoms now, but maybe 10, 15, 20 years down the line when you have that pinched nerve, when you have some pain down your arms, maybe some weakness, some numbness, then that could have been all caused by these years of keeping your head in this position.

Faith: So it sounds like Tech Neck is related to spine health.

Dr. Chan: I think it’s part and parcel. That’s exactly right.

Faith: Can you explain further how they’re connected?

Dr. Chan: When you’re fatiguing your muscles and that causes the pain, that’s the first sign that something’s going wrong. In the long term, when you keep having that fatigue on your muscles and the muscles aren’t supporting your head appropriately, you’re going to put a lot of stress on your intervertebral discs, your neck joints. And when that happens, this is when the joints overgrow or the discs start having herniations or the discs actually overgrow as well and get bigger, causing these things called osteophytes. And these are the sorts of things that then could have a different clinical presentation that, you know, when you start having nerve pinching, pain shooting down your arms, pain shooting down the sides of your neck, weakness, numbness, and tingling. That is something that starts with just, you know, today in 2024, let’s say just some neck fatigue, but it’s all related.

Faith: Tech Neck could eventually cause pain shooting down your arms?

Dr. Chan: If you ultimately get some of the end stage aspects of this cascade of things that could result from not fixing your posture, not moving your neck around, not addressing this Tech Neck now.

Everybody talks about Tech Neck, but I also think about tech back. And the issue is a lot of people are sitting in different postures because of this new technology, right, that we’re talking about: the computers, the phones and the tablets…

And the interesting thing is, people are often told, you know, sit up straight. And actually that puts a lot of stress, not only on your neck, but also on your lower back. And so if you actually sit up very straight when you’re working on your computer for those eight hours a day that you talked about, you can not only have pain and fatigue in your neck, but also that same pain and fatigue in your lower back.

Faith: So we know a lot of us are going to look down chronically, but it sounds like one of the things we need to do to address Tech Neck is to remember to change positions, to move around. Is that right?

Dr. Chan: That’s exactly right. One of the best things you can do is actually, you know, let’s say you’re in a job or a position where you can’t even get up from your seat. At the least, make sure to move your head around. You know, give your neck a gentle stretch. Maybe do a 360 circle around. Make sure that the muscles aren’t stuck in one position.

Faith: Maybe look at the ceiling?

Dr. Chan: That’s exactly right. Range of motion is great. You know, look down, look up, look side to side, rotate your head. Just make sure that you’re engaging all the other muscles as well, and loosening the ones that have been doing the work for the last several hours. The other thing that’s best, even better than that, is actually getting up and walking around.

Because, you know, if you’re just stuck in that desk, it’s not, you know, feasible for everybody, but if you can get up at least once an hour, you know, move around, walk around, it’s good. It’ll make you move your neck. But additionally, it’ll actually help circulate your blood better than when you’re sitting.

And when you’re circulating blood, first thing is you’re getting more oxygen to those fatigued muscles that need it. They’re working hard. And the other thing is that you’re then getting the inflammatory signals which create that pain. You’re actually circulating those signals away from those muscles as well.

And an interesting thing that you can do as an own test, if you’re listening to this at home, is sit in your chair and put your head forward and then lean your head all the way back. And while you’re doing that, put your hand and cup it on the back of your neck. And actually you can see how much you’re activating your neck muscles, even when you’re just sitting up straight and keeping your head up.

Faith: I feel it!

Dr. Chan: Yeah!

Now contrast that by leaning back a little bit, let’s say reclining in your chair somewhat, and then keep feeling the back of your neck, and then realize how soft those neck muscles get, and they’re not working as hard. So that’s the first thing, right? To realize, yes, you are engaging muscles when you’re sitting. And there are ways to conserve your energy.

Faith: Is there anything else that can help us strengthen our necks by way of exercise?

Dr. Chan: Well, things I like to do as part of my workouts, I actually use some resistance bands, and then actually just very lightly, I use them, you know, kind of extend my neck, you know, do several repetitions. I’m holding the ends in front of my face and then I’m extending my head backwards, uh –

Faith: Oh! But it’s wrapped around the back of your head?

Dr. Chan: Correct. Yeah. So there’s a little bit of resistance and you don’t need to go, you know, very excessive on this. You don’t want to hurt yourself, but you’ll feel it. You’ll feel, Oh, I’m actually working and engaging that muscle. And you do that several times a week. Um, that’s going to get those stronger and really help to fight off this Tech Neck symptom.

Faith: So It sounds like stretching should happen daily and perhaps multiple times a day, given how often we’re looking down at our devices. And strengthening should happen ideally a couple times a week.

Dr. Chan: Yes, I do it several times a week, two to three times a week.

Faith: So we know that slouching isn’t great for our backs and necks. And you’ve also said that sitting up rigidly is also not good for us.

So, what is the best posture to assume if we know we’re going to be sitting in front of a computer or with a phone for a few hours?

Dr. Chan: So this is the thing that’s counterintuitive to quite a few people, but it’s actually having a chair that can somewhat recline. So what happens is when you recline, you’re actually using your extensor muscles in your neck less. And then so you can still keep a similar gaze, but now you’re not using those muscles to keep your head up.

So that’s why reclining a bit in your chair can actually be very helpful to help prevent Tech Neck.

Faith: Are ergonomic chairs and desks actually helpful in this regard?

Dr. Chan: It could be depending on the type of chair.

You want to make sure that the chair has a slight recline. You want to make sure it has good lumbar support as well. And some of those desks are very helpful because one way to help prevent using a lot of your extensor muscles is bringing things to your eye level. Let’s imagine how you’re holding your phone. Often people are looking down. When they’re sitting down, they’re holding their phone in their lap and they’re looking down.

Well, anything you can do to get that phone up to your eye level, for example, putting a couple pillows, maybe their couch pillows under your elbow, so that your phone’s higher and you’re looking straight forward, is going to be helpful.

Similarly, you know, if you have one of those standing desks or a desk that shifts a lot in height, then you can increase the height of your monitor and then you can make sure that you’re looking nice and forward in a neutral position as opposed to looking down.

Faith: Before someone would have to resort to surgery, what are interventions that you end up recommending for stubborn cases of Tech Neck?

Dr. Chan: Yeah, I’m glad you said it the way you said too, because the first person you should see when you have Tech Neck is, is not a surgeon. Um, you know, certainly you should be seeing a doctor that can help with pain, but a non operative one. And we have non operative providers called PM&R doctors. That stands for physical medicine and rehabilitation. They’re also called physiatrists.

And what they do is they use non operative strategies to handle spine symptoms like Tech Neck. And most of the time you don’t need any sort of surgery. If there’s ever a time that they feel like there’s any concerning symptoms that don’t just seem like run of the mill Tech Neck, then they can send you over to us as surgeons, perhaps getting an MRI, and doing any sort of treatment if it ever comes to that.

But again, most patients with Tech Neck are never going to need surgery.

Faith: And when is surgery recommended?

Dr. Chan: So really, only if you have any of those concerning symptoms that then would indicate that you might have an underlying problem, such as a pinched nerve or a pinched spinal cord, and it’s hard because some of the symptoms overlap, but some of the symptoms that do suggest that there’s more to it than just Tech Neck are if you start having symptoms that extend outside of the neck, so let’s say radiating pain down the sides of the neck, down the shoulder, down to the hands, or you start having weakness or constant numbness and tingling. These are all signs that then say there might be something else going on. You might need a further work-up with a doctor.

Faith: This has been fascinating and has really woken me up to the way I hold my neck on my shoulders – all 10 to 12 pounds of it. Thank you so much, Dr. Chan.

Dr. Chan: Yes, of course. And thanks for having me. I think this is an important issue and I just hope more and more people realize that there’s things we can do to help with our spine health and help prevent this nagging neck pain that can affect a lot of people.

Faith: Our many thanks to Dr. Andrew Chan. I’m Faith Salie.

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