By Dr Jesse Cai at Square One Active Recovery
You would have probably heard it: bad posture is bad for you. You’ll get neck pain, you’ll damage your spinal cord, you’ll get a lump in your neck … Sounds familiar?
If you do a quick search on Google on the harmful effects of poor posture, you’d get PLENTY of hits! I am not kidding. Some of the commonly cited harms are:
Are these true?
The first thing to recognise is that good posture is strictly a social construct. What is considered as a good posture has changed through time.
At the turn of the 19th century, an upright posture was regarded as a sign of superior intelligence. During that period, physical traits were linked to everything from homosexuality to insanity to intelligence. Because the torso contains vital organs, men and women with long trunks and short legs were highly regarded.
Then came the American Posture League in 1914 (now defunct). They believed an upright posture was necessary for full health. They organised postural programs throughout American schools. Children were often stripped to their underwear for posture and testing purposes.
The current day concept of good posture hasn’t changed much since then. You would probably find the illustrations by the American Posture League still familiar.
We like to attribute neck pain as a societal norm because of the “text neck” epidemic or too much mobile phone use. But is it though?
Industrial Revolution happened during 1760 to 1820. During this period of time, there was a shift into manufacturing jobs. This meant people spent their time with their heads bent over along factory assembly lines.
During the both agricultural revolutions, people were spending more time in fields, you can see from the art works in that period showing similar instances of “bad posture”.
While mobile phone is a recent technology, “text neck” has been around for centuries if not millenniums.
While low back pain has been around throughout recorded history, disability increased exponentially in mid 1900s. Credit: Waddell 1996, Spine
Unfortunately historic data for neck pain is limited compared to lower back pain. However, if we were to look at research for low back pain, we see an exponential increase in disability beginning around the 1970s.
The increase in disability was so apparent, New York Times published an article titled The Special Pain of the Late 20th Century in 1974.
We still do not understand why low back pain has become such an epidemic but we know it only started in the last few decades.
Regardless, neck pain is one of the world’s top disorders. When it comes to the number of years lived with disability, neck pain ranks fourth out of 291 conditions. (Low back pain is #1.)
While most of your neck pain episodes will resolve within six weeks even without treatment, almost 50% of you will continue to experience some degree pain or recurrent episodes of neck pain.
In short, yes. Neck pain is an epidemic. However, “text neck” is not. It is also unlikely for “text neck” to be the cause of your neck symptoms.
The illustration below has been making rounds on social media and it does look pretty convincing. If you were to look into the actual paper (pdf accessible here), the numbers were calculated through an engineering software. There was no human studies, no cadaver studies, no animal studies!
Furthermore, it was not clear if the author took into consideration that the human neck is alive. Your cervical spine is held together by muscles and ligaments. It is robust, dynamic, and has a high capacity for load.
A paper published in 2007 (before all this “text neck” rubbish) looking at the strength of the neck in 22 cadavers found it took 250kg (2.4kN) of compressive force before causing observable damage. That is give or take 35 bowling balls!
Would you choose to believe an engineering software calculation or real studies with hard data?
This is the biggest myth we want to debunk: Bad posture or “text neck” doesn’t actually give you neck pain. We have studies to support this.
This study looked at 150 young adults (pretty decent sample size) who were asked to report their mobile phone use and rate their own posture. Their posture were then assessed separately by a registered physiotherapists.
The study reported no relationship between self-assessed neck posture and neck pain. There was no association between neck posture assessed by a physiotherapist and neck pain as well.
Your neck is good. Your neck is strong. Don’t let the internet tell you otherwise.
This is a big deal for me because it’s a FIVE year study that followed 7092 young adults (20-24 years old).
Participants WITHOUT neck pain at the start of the five year study did not develop neck pain regardless of mobile phone use. They did find an association between hand symptoms and text messaging though.
Also, no clinical guidelines ever recommended posture correction for neck pain. Go figure.
Bottom line: You can’t just bury your head in the sand and let mainstream press or urban myths feed your garbage health information. These are peer reviewed academic studies with big sample sizes!
As pain patients and consumer of health content, you should always ask for research and references. Unfortunately, we live in a time when people can get away with sharing low value, unscientific content. When in doubt, seek advice from an evidence-based and good chiropractor, physiotherapist, or healthcare professional.
This article is first published on Square One Active Recovery. To read the full article, go to Ten Text Neck and Neck Pain Facts.
Dr Jesse is an evidence-based Sport Chiropractor. Prior to moving to Singapore, he was the Head Sport Trainer at Forrestfield Football Club and had worked at various state and national level sporting clubs. He was also a board member of Sports Chiropractic Australia in 2017 and is a member of Sports Medicine Australia. Dr Jesse believes that movement is medicine and takes a rehabilitation approach to help patients achieve higher function and performance.