Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents

Abstract

Technology is an essential part of our lives. Nowadays, it is almost impossible to leave the house without a cell phone. Despite the wide range of benefits of cell phones and handheld electronic devices, this evolution of technology has not come without a price. The pandemic of cell phone use among children and young adolescents has led to the emergence of a set of musculoskeletal (MSK) symptoms that have not been seen before in this age group. These symptoms can range from neck and shoulder discomfort to pain, peripheral neurological symptoms of the upper extremity, and long-term complications such as disk prolapse and degenerative disk disease of the cervical spine. This clinical presentation is known as “text neck syndrome.” In addition to MSK symptoms, text neck syndrome could also include eye and ear symptoms, psychological problems, peripheral neurological symptoms, and poor academic performance. Multiple mechanisms have been discussed by which cell phone use causes MSK symptoms. Maladaptive postures, a decrease in physical activity leading to obesity, and the direct effect of electromagnetic radiation are some of the mechanisms by which long-term use of cell phones leads to the clinical presentation of text neck syndrome and its long-term consequences. The purpose of this article is to review the literature, discuss the epidemiology of cell phone use and MSK symptoms associated with its use in children and adolescents, describe its clinical presentation, explain the pathophysiology behind it, and provide preventative guidelines that can be used by this age group to allow for the continued use of these electronics without harmful effects on their posture and long-term health.

Prevalence and influencing factors of poor body posture among university students: a cross-sectional study from a university in eastern China

“…According to the results of the study, "participation in physical exercise", "daily exercise time", "daily sedentary time", and "frequency of snack consumption" are the most important factors in uencing the development of incorrect body posture. " important factors in uencing the development of incorrect body posture among university students [24]. Among them, "30-60 minutes of exercise per day" and "daily physical activity" have a positive impact on the development of healthy body posture among university students [25].…”

Biomechanical comparison of sagittal vertebral column bend change induced by backpacks in school-aged children and adolescents: Systematic review and network meta-analysis

“…Backpacks weighing more than 10% of a child's body weight can majorly impact their posture, potentially resulting in musculoskeletal pain and functional limitations [12,13]. Carrying backpacks that constitute 5% to 10% of body weight can cause negative postural compensations such as forward head posture, rounded shoulders, forward-leaning trunk, and increased lumbar lordosis, as well as detrimental spinal deformities [14].…”

Exercise intervention to reduce mobile phone addiction in adolescents: a systematic review and meta-analysis of randomized controlled trials

“…Sedentary behaviors and participation in specific sedentary activities (e.g., screen-based behaviors) have rapidly emerged as potential additional risk factors for adolescent health and well-being ( van Sluijs et al, 2021 ). Developing an incorrect posture with the head tilted forward due to prolonged mobile phone use may lead to problems and pain in the cervical spine and shoulders ( Warda et al, 2023 ). Previous studies have found a strong relationship between mobile phone addiction and musculoskeletal complications, leading to various musculoskeletal problems due to sedentary and prolonged static standing, which can cause muscle pain ( Toh et al, 2017 ; Xie et al, 2017 ; Zirek et al, 2020 ; Mustafaoglu et al, 2021 ) and affect work efficiency and personal quality of life.…”