Defining text neck: a scoping review

Eur Spine J. 2023 Oct;32(10):3463-3484. doi: 10.1007/s00586-023-07821-2. Epub 2023 Jul 5.


Background: Text neck is regarded as a global epidemic. Yet, there is a lack of consensus concerning the definitions of text neck which challenges researchers and clinicians alike.

Purpose: To investigate how text neck is defined in peer-reviewed articles.

Methods: We conducted a scoping review to identify all articles using the terms "text neck" or "tech neck." Embase, Medline, CINAHL, PubMed and Web of Science were searched from inception to 30 April 2022. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) guidelines. No limitation was applied for language or study design. Data extraction included study characteristics and the primary outcome relating to text neck definitions.

Results: Forty-one articles were included. Text neck definitions varied across studies. The most frequent components of definitions were grouped into five basis for definition: Posture (n = 38; 92.7%), with qualifying adjectives meaning incorrect posture (n = 23; 56.1%) and posture without a qualifying adjective (n = 15; 36.6%); Overuse (n = 26; 63.4%); Mechanical stress or tensions (n = 17; 41.4%); Musculoskeletal symptoms (n = 15; 36.6%) and; Tissue damage (n = 7; 17.1%).

Conclusion: This study showed that posture is the defining characteristic of text neck in the academic literature. For research purposes, it seems that text neck is a habit of texting on the smartphone in a flexed neck position. Since there is no scientific evidence linking text neck with neck pain regardless of the definition used, adjectives like inappropriate or incorrect should be avoided when intended to qualify posture.

Keywords: Cervical spine; Neck pain; Posture; Smartphone.

Publication types

  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Neck
  • Neck Pain / diagnosis
  • Research Design
  • Smartphone
  • Text Messaging*