Regular headaches stemming from tension in the neck? This might be caused by the use of a mobile phone or tablet. The phenomenon is also known as “Text Neck.”
Table of Contents
Homo digitalis
I’ve been suffering from recurring headaches for years. It starts with tension in the neck, and I know that a headache will follow. The pain is mainly around the edge of the skull, at the attachment of the neck to the skull. If I don’t have paracetamol nearby, it can ruin my day or night entirely. X-rays show nothing, physiotherapy points to significant tension in the neck muscles (yes, I already knew that), but massage and the prescribed exercises hardly helped. It’s so bad that I hardly train my trapezius to avoid increasing the tension, even though it used to be my best muscle group.
However, I previously attributed the cause to my working posture. I am an example of the “homo digitalis,” the new evolutionary form of humans who constantly have their shoulders pulled forward and a bent back due to daily work behind a PC. As I type this, I can already feel the tension building up again.
“Text Neck”
The term “text neck” was (as far as we know) first used in 2008 by Dr. Dean Fishman [1]. A 17-year-old patient walked into his practice complaining of head and neck pain. While Fishman was discussing the issues with the mother, he noticed the patient texting at that moment. When he saw the posture in which this was happening, he thought he had identified the cause. Dr. Fishman explains: The human head weighs on average about 4.5 kilograms in a neutral position (ears above the shoulders). For every 2.5 centimeters you tilt your head, this weight doubles. So, when looking at a mobile phone or tablet lying on your lap, your head can weigh as much as 9 to 13 kilograms.
This places increased stress on your spine, can alter its normal curve, and cause muscle pain, according to Dr. Tom DiAngelis of the American Physical Therapy Association. “It’s like holding your finger stretched back for a long time. If you stretch the tissue for a long time, it becomes painful, and inflammation can occur. It also raises questions about the long-term effects. Possible consequences such as a neck hernia and pinched nerves are considered. Text neck is becoming more common, especially among youth.
Cervicogenic headache
The difficulty doctors had in explaining my headaches apparently is not uncommon. Headaches originating from the neck are called cervicogenic headaches [2]. Text Neck is just one form of this, with the likely cause included in the name. However, with cervicogenic headaches, the cause often cannot be found after examination. X-rays and scans often show nothing, as in my case. Researchers disagree on how common it is [3,4]. The symptoms can arise spontaneously from trauma (such as “whiplash”), but can also gradually build up over the years and become increasingly severe [5,6]. The latter also applies to me. I used to be able to go to sleep when the tension arose in the evening and let it dissipate, but nowadays I have to take painkillers because I know the pain will keep me awake all night.
Cervicogenic headaches are usually caused by pressure on muscles, tendons, or nerves of the top three neck vertebrae [2]. The cause of this pressure can indeed be poor posture, such as a forward-bent neck or forward-pulled shoulders [2]. The most common similarity in complaints is the tension felt in the sub-occipital muscles (literally the muscles under the back of the skull). It is characteristic that this tension is often felt on one side (alternating sides).
Treatment: Posture
There is no medication for cervicogenic headaches other than painkillers. The advised treatment mainly consists of adjusting posture, possibly with the help of Ergotherapists. However, this is easier said than done. I am, in fact, an ergo coach at the Central Medical Archive of the AMC, which I oversee. So, I am trained to advise others on posture. I know very well what the correct posture is. Nevertheless, it is very difficult for me to continuously correct myself when I am in the wrong posture or to take enough breaks. It feels like it affects my productivity, something I think is recognizable for many. However, I should ask myself every twenty minutes if my productivity is worth a neck hernia and an average of two headaches per week.
Text Neck Indicator
There are tools to improve your posture. The Text Neck Indicator is an app that uses a green or red light to show whether you are holding your mobile phone at the correct angle. Based on the angle, it estimates the curvature of the neck.
Another interesting, but less practical, thing I found was the “neck sofa,” which I believe is nothing more than a sideways placed neck pillow, similar to the ones you use when traveling.
Treatment: Relieving tension
Massage can help reduce tension but must be done structurally (e.g., weekly), which means you quickly need a budget of €100 per month. Of course, you can also massage yourself. Look up terms like MRT (or myofascial release) and “suboccipitals” or “neck muscles” on YouTube. There you will find techniques using a tennis ball, for example. Personally, I always prefer being massaged. Besides the expertise, I find it a great advantage that you can truly relax when you don’t have to do anything yourself. But well, that costs a bit.
Chin Tuck
With the correct posture, you prevent or reduce tension, and with massage, you relieve tension. There is an exercise that does both, the so-called chin tuck. The chin tuck is pulling the chin in (giving yourself a double chin). This does two things:
- The neck extensors, the muscles that pull the head backward, become stronger. This reduces the tendency to let the head hang forward.
- The sub-occipital muscles that cause pain are stretched, allowing the tension to decrease.
- By teaching yourself to look down with a chin tuck (no matter how weird it may look), you prevent your ears from going past your shoulders. The weight of your head is then hardly increased, thus preventing the increased pressure on the neck.
Conclusion
Do you recognize the symptoms? Work on your posture. Firstly, try to become aware as often and as quickly as possible when you are in the wrong posture, no matter how difficult it may be. Then, train yourself in what your posture should be. This may feel very exaggerated at first. Especially if you’re a bit muscular, bringing your shoulders back and thus your chest forward can seem very “über-macho.” Ignore that.
Additionally, things like massage can help relieve tension, as well as the chin tuck, which also strengthens the muscles to maintain your posture correctly.
References
- edition.cnn.com/2012/09/20/health/mobile-society-neck-pain/
- physioadvisor.com.au/9273650/cervicogenic-headache-neck-headache-physioadvi.htm
- Ferrari, M., J. Haan, All about headaches and facial pain. Bruna Uitg. Utrecht, 2004, 135
- Bogduk, N., J. Govind, Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. The Lancet, 2009, 959-967
- Bogduk, N., Marsland, The cervical Zygapophysial Joints as a source of Neck Pain, 1987, Spine, 13 (6) 610-617
- Bogduk, N., A. Marsland, On the concept of third occipital headache. 1986, J. Neurol. Neurosurg. Psychiatry, 49 (7) 775-780
