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Keep your head in the right place

By Jane Langille

DR. KATHERINE TIBOR, a Costco member and chiropractor at Balanced Health Care in Toronto, wondered why her patient, an 8-yearold boy, had increased neck and shoulder pain. “There were no new activities or sports, so the cause was not obvious. Then I saw him sitting in my waiting room playing games on his dad’s cellphone one day, with his head craned all the way forward, shoulders hunched and eyes glued to the screen. I realized he might have ‘text neck’ troubles,” she says.

Tibor is one of many health-care practitioners who have noticed an increase in the number of patients of all ages with neck pain, shoulder pain and signs of early disk degeneration in the cervical spine (the upper part of the spine that supports the neck). The trend is worrying, since mobile-device usage continues to increase: The penetration of mobile de vices in Canada is 86 per cent for smartphones and 41 per cent for tablets, as of December 2015, up from 81 per cent and 38 per cent, respectively, according to digital audience measurement service comScore Inc.

Text neck

“When you stand with good posture, there is a normal curvature in your cervical spine. From a side view, it looks like the letter ‘C,’ with the curve’s convexity at the front of the neck and the concavity at the back,” explains Dr. Dean Fishman, a Costco member and chiropractor in Plantation, Florida. With text neck, the normal curvature is lost, causing a host of problems over time, including neck and shoulder pain, headaches, mood disorders and premature disk degeneration that can lead to arthritis, bone remodelling and a hunched back.


With good, neutral spine posture— ears in line with shoulders and shoulder blades pulled back—the head weighs about 4.5 to 5.5 kilograms (10 to 12 pounds). Dr. Kenneth Hansraj, a Costco member and chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine in Pough keepsie, New York, published a paper recently about the impact of forward head posture: When the head is flexed forward at an angle of 60 degrees, the effective weight of the head increases significantly, to 27 kilograms (60 pounds), putting extra stress on the cervical spine. “For a teenager with their head down two to four hours daily, that can add up to [136,000 kilograms; 300,000 pounds] of repetitive stress over 5,000 hours during high school,” says Hansraj.

Don’t stick your neck out for tech

In a case study of patients age 13 to 27 at his practice, Fishman instructed half of the participants to use their device at eye level every time. The other half used their devices as usual. Both groups received physical therapy, exercises and chiropractic treatment. After one month of care, patients in both groups reported decreased pain and showed improved results for range of motion and X-ray findings, but those who used their devices at eye level experienced a significantly greater correction in cervical spine curvature.

For Tibor’s 8-year-old patient, she recommended his parents limit his time on screen and ensure that he takes a break every 20 minutes. She also advised that he prop his tablet up, rather than look down at a tabletop or his lap. “After a few treatment sessions and some homework exercises, he started feeling better within a week,” says Tibor.

That’s great news, since people are not about to give up texting, searching, posting on social media, accessing emails or watching videos on their phones anytime soon.

Jane Langille (janelangille.com) is a Toronto-area health and medical writer.

Article referenced from: In the Costco Connection  Canada – July/ August 2016

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