Is "text neck" real?

Look up neck pain and phones and you will soon meet text neck: the idea that looking down at a screen loads your neck with up to 60 pounds and wears out your spine. It is a vivid picture. The research behind it is thinner than the headlines suggest, and the studies that tested it in real people point somewhere else.

What people mean by text neck

Text neck is a name for the posture most of us take when we use a phone: head tipped forward, chin down, eyes on the screen. Behind the name sits a claim. Hold that position for hours a day, the claim goes, and it strains the cervical spine and causes neck pain.

Researchers who study it describe it as a hypothesis: that the neck posture people adopt when texting and reading on a smartphone is related to the rise in neck pain (Correia et al., 2021). The word that matters there is hypothesis. Text neck describes a posture and a theory about it. The question is whether the theory holds up.

Where the 60-pound figure comes from

The best-known number comes from a short paper published in 2014 by KK Hansraj of New York Spine Surgery & Rehabilitation Medicine. Its stated aim was to assess the forces the cervical spine sees as the head is tilted further forward (Hansraj, 2014).

It did this with a model of the neck, not with people. According to the model:

• an adult head held upright puts about 10 to 12 pounds (roughly 5 kg) on the neck;
• at 15 degrees of forward tilt, the load rises to 27 pounds (about 12 kg);
• at 30 degrees it is 40 pounds, and at 45 degrees 49 pounds;
• at 60 degrees, it reaches 60 pounds (about 27 kg).

Beyond 60 degrees, the model could no longer give a figure (Naresh-Babu et al., 2019, summarising Hansraj).

What a model can and cannot tell you

The logic is mechanical. The further the head sits in front of the spine, the more force it takes to hold it there, a bit like holding a bag at arm’s length rather than close to your chest.

But a model is a calculation. It describes forces in a fixed position at one moment. It did not involve anyone with or without neck pain, it did not follow anyone over time, and it did not look at how long people actually hold their heads down or how often they move.

So the model can tell you that looking down increases the load on the neck. It cannot tell you whether that load causes pain. To answer that, you have to measure real people.

What happened when researchers measured real people

That is exactly what two studies set out to do.

The first looked at 150 young adults aged 18 to 21 from a public high school in the state of Rio de Janeiro, Brazil. Each typed a text message on a mobile phone while their neck posture was judged twice: by the participants themselves and by physiotherapists watching them. They also filled in a questionnaire about neck pain and about other things that might muddy the picture, such as time spent on the phone, eyesight and how much they worried about their posture.

Whichever way posture was judged, there was no association between neck posture while texting and neck pain, or between posture and how often the pain came (Damasceno et al., 2018). The authors wrote that their findings challenge the belief that neck posture while texting is linked to the growing prevalence of neck pain.

The second study, by several of the same researchers, asked the same question in a bigger and older group: 582 adults aged 18 to 65. This time the neck angle was measured with an instrument, a cervical range of motion device, while people typed a message on their smartphones, once standing and once sitting.

Neither angle was linked with having neck pain, with how often it came or with how bad it was at its worst (Correia et al., 2021).

The limits of these studies

Both studies were cross-sectional: they took one snapshot of each person. A posture measured while typing one message may not reflect how someone holds their phone over a whole day. The first study came from a single school. And finding no association is not proof that posture never matters for anyone.

Still, these two studies tested the text neck claim directly, in 732 people between them. Neither found what the idea predicts: that the people who bend their necks most while texting are the ones with neck pain.

Phones and neck pain: a different question

That does not mean phones are irrelevant. A 2025 review pooled seven studies with 10,715 people, with average ages between about 20 and 43. People who overused their smartphones had higher odds of neck pain than people who did not, an adjusted odds ratio of 2.34, or more than double the odds (Chen et al., 2025).

Two cautions. All seven studies were retrospective, so they can show a link but not a cause. And they compared people by how much they used their phones, not by the angle of their necks. Heavy phone use might go with neck pain because of the time spent in one position, or for reasons that have little to do with the neck at all. The review cannot tell us which.

Put next to the posture studies, it suggests a reframing. The amount of phone use may matter more than the exact angle you hold it at.

What about forward head posture?

Text neck is about the angle while you look down at a phone. Forward head posture is about where your head usually sits relative to your shoulders, phone or no phone. Here the evidence looks a little different.

A review of 15 studies found that adults with neck pain had, on average, more forward head posture than adults without it, and that more forward head posture went with more pain and disability in adults and older adults. In teenagers, there was no such difference. The authors also found that age played an important part in the relationship (Mahmoud et al., 2019).

Again, these were cross-sectional studies. They cannot tell whether the posture leads to the pain, whether pain changes how people hold themselves, or whether something else drives both. If you are curious where your own posture sits, the wall posture test is a simple self-check.

So, is text neck real?

It depends on which part of the claim you mean.

• Looking down increases the load on your neck. A computer model says so, and the mechanics make sense.
• The angle you hold your phone at causes neck pain. Not shown. Two studies that measured it in real people found no link.
• Heavy phone use goes with more neck pain. Likely, going by one review, but the studies so far cannot say why, or which way round it works.

This fits a wider rethink of posture. In a 2019 viewpoint, a group of authors pointed out that the common belief that spinal pain comes from sitting, standing or bending “incorrectly” lacks strong evidence, even though a large industry has grown up selling products that claim to correct posture (Slater et al., 2019). If you have been tempted by one of those products, Do posture correctors work? looks at the evidence.

What seems to matter more than the angle

NHS guidance does not single out a forbidden angle. The NHS lists bad posture, for example sitting at a desk for a long time, as a common cause of neck pain, and its advice is not to keep your neck in the same position for a long time (NHS). NHS inform lists “being in the one position too long” among the common causes, and suggests moving your neck for short periods every hour (NHS inform).

The common thread is time in one position, not one bad posture. In practice that points to a few low-stakes habits:

• Change position often, whether you are on a phone, a laptop or a sofa.
• Build short breaks into the day. Our guide to microbreaks looks at how often to move.
• Hold your phone higher if it feels better, but do not treat a perfect angle as the goal.
• Raise a laptop screen if you work on one for hours, so you spend less of the day looking down. See working on a laptop without straining your neck.

If your neck already hurts, the more useful question is what helps, and there is more research to go on. Do stretches help neck pain from desk work? goes through it.

Bavelu’s posture tracking uses the motion sensor in your AirPods to notice when your head leans forward and let you know. In the light of the research above, treat that as a nudge to move or change position, not a warning that something is being damaged. How AirPods can track your head posture explains how it works.

When to see a doctor

According to NHS inform, neck problems are rarely caused by serious disease or damage, and most new ones improve within eight weeks. Contact your GP practice urgently, or phone 111 if it is closed, if:

• you notice clumsiness in your hands, or numbness, pins and needles or weakness in one or both arms that is getting worse;
• you have had problems with balance or walking since the neck pain started;
• your neck pain comes with a severe headache.

Contact your GP practice if you also feel generally unwell, if the pain starts while you are ill with another condition such as rheumatoid arthritis or cancer, or if you develop blurred vision, ringing in your ears or dizziness (NHS inform). The NHS also advises seeing a GP if neck pain or stiffness does not go away after a few weeks, if painkillers have not helped, or if you are worried (NHS). Our page on neck pain from desk work covers the causes and the warning signs in more detail.