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November 24, 2014 at 10:40 AMComments: 0 Faves: 1

Texting: The Unexpected Side-Effects

By Jeffrey VanWingen M.D. More Blogs by This Author

Call me old fashioned.  I had never fathomed that the biggest gape in the generation gap with my teenage daughter would be over use of technology.  While we find common ground in music, movies and cuisine, we just can't come to terms with our cellular communication.  I pay for her cell phone in order to maintain contact with her.  It's a nice notion that I can hear her voice and communicate information at any time.  She sees it a bit differently.  Phone calls are a nuisance-- it's all about texting these days.  Missed calls and a voice message are left with a texted reply.  This philosophical and preferential division actually got heated in a classic generational gap.  When I expressed that my thumbs don't like to do what my voice was made for I was quickly put in the outdated and uncool box that didn't fit in with a younger, technologically advanced culture. 

I worry about this culture of texting, however-- more than just the "LOL" mentality of endless abbreviations and poor grammar.  As a family doctor, I am seeing the consequences of "overtexting" on health.  This blog will outline common health issues resulting from excessive texting.

Neck Strain

Texting puts our body into an unnatural posture.  You've seen people engaged in texting with shoulders rolled forward, head down and neck flexed, gripping onto the device.  This positioning of the body is not ergonomic and produces excessive strain, especially when sustained for longer than brief periods.  Most human heads weigh at least 10 pounds which is about the same as a bowling ball.  This weight is balanced on the cervical (neck) spine which seems to balance the head effortlessly.  New data shows, however, how increasing flexion of the neck as seen in texting can place a tremendous burden on the spine of the neck.

Ergonomic modeling was performed measuring neck strain.  When the head was upright on the spine at zero degrees of flexion, the load was manageable in bearing just that 10 pounds.  With tilting forward, however, the load on the spine increases with each degree of flexion.  At just 15 degrees which is a mild tilting forward of the neck, the load on the spine increases to 27 pounds.  When this increases to 60 degrees of flexion, typical for looking down at a smartphone held at the chest, the load on the spine increases to 60 pounds!  To illustrate this principal, go into your cupboard and grab a can.  Hold the can close to the body and then extend your arm further our from your body to maximum distance.  Notice how the strain on the body form the can's weight increases as you extend the arm outward.

With six times the neck strain in flexing, habitual positioning is going to take a toll.  Excessive texting in this position is going to lead to neck and shoulder pain.  Beyond this, degenerative changes will develop leading to decreased flexibility, chronic pain and even compromise of the spinal cord and nerves requiring surgical correction.

Texting Thumb

It's impressive watching the thumbs of an avid texter fly across the tiny keyboard to manage communications.  According to the Pew Research Center's 2012 data, the average American teenager sends around 1800 texts per month.  This repetitive thumb use in texting with perhaps some video game play thrown in there can lead to injury in the intricate tendons which make the thumb universal in its abilities. 

For the most part, our thumbs enable us to grip.  While precise movement in the various planes of the hand (side-side and up-down) is well within the capabilities of the thumb, these are more meant for fine tuning movements and not repetitive work.  The movements of texting with extended wrists and rapid fine movement of the thumb causes a cramped sawing motion of certain thumb tendons in their sheaths meant to reduce friction.  These sheaths and tendons can subsequently develop inflammation causing severe pain and reduced abilities.  When the inflammation is significant, it is known as DeQuervain's Syndrome.  With this problem, inflammation of not only the tendon but the sheath tasked with making the slippery lubricant enabling the tendon to glide freely causes a locking and freezing of the thumb along with pain.  Anti-inflammatory medication and physical therapy are often required to help this condition.

Disordered Sleep

In the digital world, excessive exposure to backlit screens found in computer monitors, televisions and cell phones is receiving a lot of attention.  Researchers at The Rensselaer Polytechnic Institute found that just two hours of exposure to backlit screens reduced the brains melatonin secretion by 22%.  This can affect the body's sleep-wake cycle and lead to disordered sleep.  Other research has found that when this exposure happens within two hour of intended sleep time, the quality of sleep suffers.  Laying in bed texting is a contributor to both of these issues negatively impacting sleep quality.


I feel that text messaging is a good piece of technology appreciated by today's society.  But, as with many things, too much of a good thing can turn the tables.  For those who rely heavily on texting, get smart about smartphone use.  Limit the amount of texting as you are able.  Tend to your posture and remedy excessive flexion of the neck paying attention to ergonomics.  Consider using the voice recognition application on your texting to reduce strain on your thumbs.  Lastly, try to keep exposure to backlit screens to under two hours per day and limit this exposure especially before bedtime.

Live, and live well.  TTFN :)


1. Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head, Hansraj et al, Surgical Technology International, 2014.

2. Teens, Smartphones and Texting, Pew Internet and American Life Project, March 12 2012.

3. Light Level and Duration of Exposure Determine the Impact of Self-luminous Tablets on Melatonin Suppression,  Figueiro et al, Applied Ergonomics Journal, March 2013.

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