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Tech Neck (Text Neck): What the Evidence Really Shows

Tech neck picture

By Mr Ahmed-Ramadan Sadek, Neurosurgeon · 12 min read

🎧 Listen to this guideAbout 8 minutes. Narrated in Mr Sadek’s voice using AI voice technology, from a script he has reviewed.

On this page

Key points

  • Tech neck, or text neck, means bending your head forward to look at a phone, tablet or laptop. It is a popular label, not a medical diagnosis, and researchers do not agree on a definition.[1]
  • Looking down does make the neck muscles work harder. The well-known figure of 27 kg at 60 degrees comes from a single computer model, not from measurements in people, and it did not test whether that load causes pain or damage.[2]
  • Studies that measured how far people actually bend their neck while texting have not found that a more bent neck leads to neck pain, including one that followed 457 adults for a year.[3][4]
  • Heavy or compulsive phone use, long screen time and long spells without moving are linked with more neck pain in some studies. Most of these studies cannot show cause and effect.[5][6][7]
  • Neck and shoulder strengthening exercise has the best evidence for easing long-term neck pain and may lower the chance of a new episode. Changing position often and staying active are sensible, low-cost habits.[8][9]

Seek urgent medical help (A&E or 999) if you have neck pain with:

  • Rapidly worsening clumsiness of the hands, or new problems with balance and walking.
  • Weakness, numbness or tingling spreading into the arms or legs.
  • Numbness around the genitals or back passage, or loss of bladder or bowel control.
  • Pain after a significant injury, such as a fall or road traffic accident.

Hand clumsiness and balance problems can be signs of pressure on the spinal cord in the neck. Neck pain with fever, feeling unwell, unexplained weight loss or a history of cancer also needs prompt medical assessment.[10]

What is tech neck?

Tech neck (also called text neck) describes the head tipped forward and down to look at a screen held low, usually a phone. The term is widely used, but it is not a diagnosis. A 2023 scoping review found 41 published articles using the term and no agreed definition. Most defined it by posture, some by overuse, and a few by tissue damage. The review authors concluded that, whatever definition is used, there is no scientific evidence linking text neck with neck pain, and that words such as “inappropriate” or “incorrect” should not be used to describe the posture.[1]

This guide looks at the research behind the claims. It builds on our shorter overview of posture, tech neck and standing desks, and our separate guide covers sit-stand desks and spinal health.

How far do people really bend their neck?

Quite a lot. In a laboratory study of 18 people, the typical head angle while using a phone was 33 to 45 degrees from upright, with the most bend when texting while seated.[11] When 31 students wore a sensor for a normal 8-hour day, they used their phones for about two hours, and head tilts of more than 30 degrees were much more common while they were on the phone.[12] People walking while texting held their heads at about 31 to 39 degrees.[13]

The 27 kg claim: where it comes from

You may have read that tilting your head forward 60 degrees puts 27 kg (60 pounds) of force on your neck. This figure comes from a three-page paper published in 2014 by a New York spine surgeon. He built a computer model of the neck and calculated the force at different angles.[2]

Head positionForce on the neck in the model
Upright10 to 12 pounds (about 5 kg)
15 degrees forward27 pounds (about 12 kg)
30 degrees forward40 pounds (about 18 kg)
45 degrees forward49 pounds (about 22 kg)
60 degrees forward60 pounds (about 27 kg)

Figures from Hansraj 2014, converted to kilograms and rounded.[2]

How strong is this evidence?

The physics behind it is reasonable. The further your head moves forward of your spine, the harder the muscles at the back of the neck have to work to hold it up. But the paper has important limits, which are rarely mentioned when the number is repeated:[2]

  • It is a computer model. No people were measured, and the paper does not report checking the model against real measurements.
  • It gives a single set of numbers for an average head. It does not say how much these figures vary from person to person.
  • The paper suggests these forces “may” lead to early wear, degeneration and possibly surgery. That was not tested in the study.
  • It did not look at pain at all.

Later research using more detailed models supports the general idea, though not the exact figures. One study combined X-rays of each person’s neck with a muscle model and found that the demand on the neck muscles while using a tablet was 3 to 5 times that of sitting upright. Demand was lowest when the tablet was propped up high.[14] Another study of 32 young adults found that the load on the neck, and the activity in the neck muscles, rose as the neck bent further, and that neck discomfort was lowest when the neck was upright.[15] A systematic review of 12 laboratory studies found that phone use increased neck muscle activity and head flexion, and that sitting caused more head-neck bending than standing. The reviewers rated the studies as moderate quality.[16]

The key point: looking down at a phone does make your neck muscles work harder. That is not the same as showing it harms your spine. Muscles are built to work, and none of these laboratory studies followed people over time to see whether the extra load led to pain or damage.

Does looking down at your phone cause neck pain?

To answer this, researchers need to measure people’s neck posture while they use their phones and then compare it with neck pain. Several studies have done this, and none found a link between how far the neck bends and neck pain.

  • 150 young adults aged 18 to 21 (Brazil): neck posture while texting, judged by the participants and by physiotherapists, was not linked with neck pain or how often it happened.[17]
  • 582 adults aged 18 to 65 (Brazil): neck bend measured with a device while texting, standing and sitting, was not linked with having neck pain, how often it came on or how bad it was.[3]
  • 238 university students (Italy): neither neck posture while using the phone nor hours of phone use was linked with neck pain or disability.[18]
  • 457 adults without neck pain, followed for 12 months (Brazil): this is the strongest study so far because it looked forward in time. A more bent neck while texting did not raise the chance of developing neck pain. Poor sleep and not being active enough did.[4]

Studies of general sitting posture point the same way. In the Australian Raine Study, the sitting posture of 17-year-olds did not predict persistent neck pain at age 22 in young men. In young women, those who sat in a slumped or relaxed way were less likely to have persistent neck pain than those who sat upright.[19]

What about forward head posture?

Forward head posture means the head sitting forward of the shoulders when standing or sitting normally. The evidence here is more mixed. A 2019 review of 15 studies found that adults with neck pain had slightly more forward head posture than adults without pain, and that more forward posture went with more pain and disability. In teenagers, no such difference was found.[20] A 2023 review of 26 studies found that one measure of head posture (the craniovertebral angle) differed between people with and without neck pain, while other measures did not.[21]

All of these studies measured posture and pain at the same time. They cannot show which came first. People with a painful neck may hold their head differently because of the pain, rather than the other way round.

So why are phones linked with neck pain in some studies?

Other studies have looked at how much people use their phones, rather than their posture, and some have found links:

  • A 2025 review pooled seven studies with 10,715 people. Those who scored as overusing their phones, usually on a smartphone addiction questionnaire, had about twice the odds of neck pain. All seven studies looked back in time, which is a weaker design.[5]
  • In 1,602 office workers in Iran, phone overuse was linked with about six times the odds of neck pain. Phone overuse was also linked with anxiety, stress and low mood.[22]
  • In 1,691 teenagers in Singapore followed for a year, phone and tablet use were linked with later neck and shoulder symptoms. The number of hours of use was not. The pattern of use, such as long unbroken spells and multitasking, seemed to matter more.[6]
  • In 45,555 Danish 11-year-olds, six or more hours of screen time a day was linked with roughly double the risk of severe spinal pain compared with under two hours. Being physically inactive added to the risk. This study measured screen time and pain at the same time.[7]

Put together, the research suggests the problem, where there is one, is less about the angle of your neck and more about what goes with heavy screen use: long spells without moving, less physical activity, poorer sleep and, in some people, stress. These are things you can change.

What predicts neck pain in office workers?

Neck pain is common in people who work at computers, and many causes have been suggested. A review of prospective studies found strong evidence for only two predictors: being female and having had neck pain before. Many commonly blamed factors showed no predictive value.[23] A later review found modest links with a keyboard placed close to the body, little variety in work tasks, low satisfaction with the workplace and feeling that your muscles are tense.[24]

Common myths

MythWhat the evidence shows
Looking down at your phone puts 27 kg on your neck and wears it out.The 27 kg figure is a computer estimate for a 60 degree bend. Wear and damage were not measured.[2]
Phones are making young people grow horns on their skulls.A 2018 study of skull X-rays found bony bumps at the back of the skull were linked with forward head posture. The authors only suggested that phones might be involved; phone use was not measured. One author declared that he offers posture services and products.[25]
Losing the curve in your neck on an X-ray causes neck pain.A study of 107 people over 45 found no difference in neck curve between those with and without neck pain. The authors concluded such findings may be coincidental.[26]
You must keep your neck perfectly straight to avoid pain.Studies measuring neck bend while texting have not found a link with pain. Varying your position matters more than holding one ideal posture.[4][27]
Tech neck is a new epidemic causing permanent damage.There is no agreed definition and no evidence linking it with neck pain, let alone permanent damage.[1]

What helps: exercise

Exercise has the strongest evidence for neck pain, especially exercise that strengthens the neck, shoulders and upper back.

  • Cochrane review, 27 trials: for long-term neck pain, moderate quality evidence supports neck, shoulder and shoulder-blade strengthening for reducing pain, by a moderate to large amount straight after treatment. Combined strengthening and stretching also helped. Stretching on its own may not.[8]
  • Office workers with long-term neck pain: a 2024 review of eight trials found strengthening exercise reduced neck pain and disability, though the certainty of the evidence was low.[28]
  • How much exercise? In a Danish trial of 447 office workers, one hour a week of supervised strength training for 20 weeks reduced neck pain. It worked whether the hour was done in one session, three 20-minute sessions or nine sessions of about 7 minutes.[29]
  • Prevention: a 2023 review of five trials, mostly in office workers, found moderate certainty evidence that exercise programmes roughly halve the odds of a new episode of neck pain over the next year. How much difference this makes to an individual is less clear.[9]
  • Forward head posture: a review of seven trials found exercise can change head posture and moderately improve neck pain. The authors noted it is still unclear how changes in posture relate to changes in pain.[30]

NICE’s summary for GPs recommends reassurance, staying active, and physiotherapy that may include stretching, strengthening and range of motion exercise. It also lists yoga, Pilates, Tai Chi and Qigong as exercise options.[10] See our guides to stretching for the back and neck and physiotherapy for back and neck pain.

What helps: changing how you use your screens

Changes to equipment have weaker evidence than exercise. A Cochrane review of office ergonomics found only inconsistent evidence for things like arm supports and different mice, no clear effect from adjusting workstations, and very low quality evidence that extra breaks reduced neck discomfort.[31] NICE’s summary for GPs suggests identifying and correcting postural factors in daily activities and work where possible, but notes that this advice is based on expert opinion rather than trials.[10]

So treat the tips below as ways to stay comfortable, not as rules that protect your spine. They are cheap, and many people find them helpful.

  • Bring the screen up a little. Neck muscle demand was lowest when a tablet was propped up high.[14] Rest your elbows on a table or your knees, or use a stand.
  • Break up long spells. Unbroken stretches of use seem to matter more than total hours.[6] The Health and Safety Executive (HSE) advises short, frequent breaks, for example 5 to 10 minutes every hour rather than 20 minutes every two hours.[32]
  • Set up your desk for comfort. The HSE suggests the top of the screen roughly level with your eyes, about an arm’s length away, and a separate keyboard and mouse with the screen raised if you use a laptop for long periods.[33]
  • Move between positions. Do not hold your neck in one position for long periods, such as at a desk.[34]
  • Look after the basics. Poor sleep and low physical activity predicted new neck pain in the 12-month study, while neck angle did not.[4]
  • Use a firm pillow. If your neck is sore, a single firm pillow may help at night.[10] Read more in our guide to sleep and back pain.

If your neck is already sore, the NHS suggests sitting upright and gently rolling your shoulders back, keeping your neck moving, and not wearing a neck collar unless a doctor advises it.[34] That is sensible comfort advice. It does not mean a bent neck caused the pain in the first place.

Mr Sadek’s earlier video, Tech Neck Takedown, is below as extra viewing.

When to see a doctor

Most neck pain gets better within a few weeks.[10] See a GP if:[34]

  • Neck pain or stiffness does not go away after a few weeks.
  • Painkillers have not helped.
  • You are worried about the pain.
  • You have other symptoms such as pins and needles or a cold arm.

In many areas you can refer yourself to NHS physiotherapy without seeing a GP first.[34] Pain that spreads down the arm with numbness or weakness may come from a trapped nerve in the neck; see our guide to cervical radiculopathy. Clumsy hands or unsteady walking need prompt assessment; see our guide to cervical stenosis and myelopathy.

Questions to ask

  • Is there anything in my examination that suggests more than simple neck pain?
  • Which strengthening exercises should I do, how often, and for how long before we review?
  • Do I need a scan, and would it change my treatment?
  • Is there anything about my work set-up or routine you would change?

Frequently asked questions

Is tech neck a real medical condition?

Not as a diagnosis. It is a popular name for looking down at a screen. A review of 41 articles found no agreed definition, and no evidence linking it with neck pain, whichever definition was used.[1] Neck pain itself is real and common, and most of it gets better within a few weeks.[10]

Is the 27 kg figure true?

It is a calculation, not a measurement. It comes from a computer model in a 2014 paper and applies to a 60 degree bend; at 15 degrees the same model gives about 12 kg.[2] Other studies agree that the neck muscles work harder when you look down,[14] but none has shown that this extra work damages the spine.

Can looking down at my phone damage my spine permanently?

There is no good evidence that it does. Studies that measured how far people bend their neck while texting have found no link with neck pain, including one that followed adults for a year.[3][4] Claims about wear, degeneration or bony growths come from theory or studies that did not measure phone use.[2][25]

Why does my neck ache after a long time on my phone?

Holding any position for a long time can make muscles ache, and looking down makes the neck muscles work harder.[15] The ache is a signal to move, not a sign of damage. Taking breaks, raising the screen and changing position usually help.[32]

Should I buy a posture corrector or special pillow?

There is no strong evidence that correcting posture prevents pain, and the products are sold with confident claims.[27] Strengthening exercise has much better evidence for neck pain.[8] For sleep, a single firm pillow is the usual advice.[10]

Are children and teenagers at more risk?

Studies in young people are mixed. Teenagers’ sitting posture at 17 did not predict neck pain at 22,[19] but long unbroken spells on phones and tablets,[6] and very high screen time with little physical activity,[7] have been linked with more neck and back pain. Encouraging breaks and plenty of physical activity is sensible.

Which exercises help most?

Strengthening the neck, shoulders and upper back has the best evidence for long-term neck pain.[8] About an hour a week, split however suits you, reduced neck pain in office workers.[29] A physiotherapist can show you exercises that suit you.

Do I need an X-ray or scan?

Usually not. NICE’s summary for GPs says the diagnosis of simple neck pain is made from the history and examination, and X-rays and other scans are not routinely needed.[10] Changes in the neck’s curve on X-ray are common in people without pain.[26]

Further reading

References

  1. Grasser T, Borges Dario A, Parreira PCS, Correia IMT, Meziat-Filho N. Defining text neck: a scoping review. Eur Spine J. 2023;32(10):3463-3484. Link
  2. Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014;25:277-279. Link
  3. Correia IMT, Ferreira AS, Fernandez J, Reis FJJ, Nogueira LAC, Meziat-Filho N. Association between text neck and neck pain in adults. Spine (Phila Pa 1976). 2021;46(9):571-578. Link
  4. Correia IMT, Ferreira AS, Gomes JFM, Reis FJJ, Nogueira LAC, Meziat-Filho N. Cervical flexion posture during smartphone use was not a risk factor for neck pain, but low sleep quality and insufficient levels of physical activity were. A longitudinal investigation. Braz J Phys Ther. 2025;29(6):101258. Link
  5. Chen YJ, Hu CY, Wu WT, et al. Association of smartphone overuse and neck pain: a systematic review and meta-analysis. Postgrad Med J. 2025;101(1197):620-626. Link
  6. Toh SH, Coenen P, Howie EK, et al. A prospective longitudinal study of mobile touch screen device use and musculoskeletal symptoms and visual health in adolescents. Appl Ergon. 2020;85:103028. Link
  7. Joergensen AC, Strandberg-Larsen K, Andersen PK, Hestbaek L, Andersen AN. Spinal pain in pre-adolescence and the relation with screen time and physical activity behavior. BMC Musculoskelet Disord. 2021;22(1):393. Link
  8. Gross A, Kay TM, Paquin JP, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015;1(1):CD004250. Link
  9. Teichert F, Karner V, Döding R, Saueressig T, Owen PJ, Belavy DL. Effectiveness of exercise interventions for preventing neck pain: a systematic review with meta-analysis of randomized controlled trials. J Orthop Sports Phys Ther. 2023;53(10):594-609. Link
  10. National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Neck pain, non-specific (summary, assessment and management). Last revised April 2023. Link
  11. Lee S, Kang H, Shin G. Head flexion angle while using a smartphone. Ergonomics. 2015;58(2):220-226. Link
  12. Han H, Lee S, Shin G. Naturalistic data collection of head posture during smartphone use. Ergonomics. 2019;62(3):444-448. Link
  13. Han H, Shin G. Head flexion angle when web-browsing and texting using a smartphone while walking. Appl Ergon. 2019;81:102884. Link
  14. Vasavada AN, Nevins DD, Monda SM, Hughes E, Lin DC. Gravitational demand on the neck musculature during tablet computer use. Ergonomics. 2015;58(6):990-1004. Link
  15. Tapanya W, Puntumetakul R, Swangnetr Neubert M, Boucaut R. Influence of neck flexion angle on gravitational moment and neck muscle activity when using a smartphone while standing. Ergonomics. 2021;64(7):900-911. Link
  16. Eitivipart AC, Viriyarojanakul S, Redhead L. Musculoskeletal disorder and pain associated with smartphone use: a systematic review of biomechanical evidence. Hong Kong Physiother J. 2018;38(2):77-90. Link
  17. Damasceno GM, Ferreira AS, Nogueira LAC, Reis FJJ, Andrade ICS, Meziat-Filho N. Text neck and neck pain in 18-21-year-old young adults. Eur Spine J. 2018;27(6):1249-1254. Link
  18. Bertozzi L, Negrini S, Agosto D, et al. Posture and time spent using a smartphone are not correlated with neck pain and disability in young adults: a cross-sectional study. J Bodyw Mov Ther. 2021;26:220-226. Link
  19. Richards KV, Beales DJ, Smith AL, O’Sullivan PB, Straker LM. Is neck posture subgroup in late adolescence a risk factor for persistent neck pain in young adults? A prospective study. Phys Ther. 2021;101(3):pzab007. Link
  20. Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Curr Rev Musculoskelet Med. 2019;12(4):562-577. Link
  21. Rani B, Paul A, Chauhan A, Pradhan P, Dhillon MS. Is neck pain related to sagittal head and neck posture? A systematic review and meta-analysis. Indian J Orthop. 2023;57(3):371-403. Link
  22. Derakhshanrad N, Yekaninejad MS, Mehrdad R, Saberi H. Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers. Eur Spine J. 2021;30(2):461-467. Link
  23. Paksaichol A, Janwantanakul P, Purepong N, Pensri P, van der Beek AJ. Office workers’ risk factors for the development of non-specific neck pain: a systematic review of prospective cohort studies. Occup Environ Med. 2012;69(9):610-618. Link
  24. Jun D, Zoe M, Johnston V, O’Leary S. Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis. Int Arch Occup Environ Health. 2017;90(5):373-410. Link
  25. Shahar D, Sayers MGL. Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups. Sci Rep. 2018;8(1):3354. (Author correction: Sci Rep. 2019;9(1):13707.) Link
  26. Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16(5):669-678. Link
  27. Slater D, Korakakis V, O’Sullivan P, Nolan D, O’Sullivan K. “Sit up straight”: time to re-evaluate. J Orthop Sports Phys Ther. 2019;49(8):562-564. Link
  28. Jones LB, Jadhakhan F, Falla D. The influence of exercise on pain, disability and quality of life in office workers with chronic neck pain: a systematic review and meta-analysis. Appl Ergon. 2024;117:104216. Link
  29. Andersen CH, Andersen LL, Gram B, et al. Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial. Br J Sports Med. 2012;46(14):1004-1010. Link
  30. Sheikhhoseini R, Shahrbanian S, Sayyadi P, O’Sullivan K. Effectiveness of therapeutic exercise on forward head posture: a systematic review and meta-analysis. J Manipulative Physiol Ther. 2018;41(6):530-539. Link
  31. Hoe VC, Urquhart DM, Kelsall HL, Zamri EN, Sim MR. Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers. Cochrane Database Syst Rev. 2018;10(10):CD008570. Link
  32. Health and Safety Executive. Working safely with display screen equipment: 4. Work routine and breaks. Link
  33. Health and Safety Executive. Working safely with display screen equipment: 3. Good posture when using display screen equipment. Link
  34. NHS. Neck pain. NHS website; page last reviewed 27 April 2023. Link

This article is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist before making any change to your treatment.

Last checked: October 2026