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Teens' compulsive texting can cause neck injury

Head bowed over a cellphone while texting for long periods of time is a posture that can eventually lead to spinal disk damage.

While examining an X-ray of a 17-year-old patient's neck x-ray in 2009 we noticed something unusual. The ghostly image of her vertebral column showed a reversal of the forward curvature that normally appears in the cervical spine — a degenerative state we most often seen in middle-aged people who had spent several decades of their life in poor posture or whiplash victims.

That's when I looked over at the patient. She was slumped in her chair; head tilted downward, madly typing away on her cellphone. When I mentioned to the patient's mother that the girl's posture could be causing her headaches, I got what could be described as an "emotional response." It seemed the teen spent much of her life in that position.

Prolonged periods of tilting her head downward to peer into her mobile device had created excessive strain on the cervical spine, causing a repetitive stress injury that ultimately led to spinal degeneration. We began looking through all the recent X-rays we had of young people — many of whom had come in for neck pain or headaches — and we saw the same thing: signs of premature degeneration.

The head in neutral has a normal weight of 10 to 12 pounds. That neutral position is ears over shoulders with shoulder blades pulled back. If you start to tilt your head forward, with gravity and the distance from neutral, the weight starts to increase.

A recent study in the journal Surgical Technology International quantified the problem: As the head tilts forward 15 degrees from neutral, the forces on the cervical spine and supporting musculature increase to 27 pounds. As the tilt increases, the forces increase to 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees.

"When your head tilts forward, you're loading the front of the disks," says Dr. Kenneth Hansraj, study author and chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine. Though the study didn't look at long-term effects of this position, Hansraj says that, after seeing approximately 30,000 spinal surgery patients, he's witnessed "the way the neck falls apart."

He explains, "When you're eccentrically loading the spine, you're going to get cracks in the disks, slipped disks or herniated disks. This leads to stenosis or blockage of the spine."

In addition the “text-neck posture” can lead to pinched nerves, arthritis, bone spurs and muscular deformations. The head and shoulder blades act like a seesaw. When the head goes forward, the shoulder blades will flare out … and the muscles start to change over time.

Much like tennis elbow doesn't occur only in people who play tennis, text neck isn't exclusive to people who compulsively send text messages. People in high-risk careers include dentists, architects and welders, whose heavy helmets make them especially vulnerable. He adds that many daily activities involve tilting the head down, but they differ from mobile-device use in intensity and propensity.

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