Tech neck, also known as text neck, is an increasingly prevalent musculoskeletal condition caused by prolonged forward head posture associated with the use of electronic devices. Characterized by neck pain, stiffness, and postural imbalances, tech neck is particularly common among adolescents and working adults.
At True Sport Care, we see first-hand how digital technology has reshaped daily life – and not always for the better. About 75–80% of our patients come in with aches and pains directly related to computer or phone use. Almost every one of my patients either works on a computer, is in school and uses the computers in class or to study. The patients that are not using computers or tablets in this way are playing video games for hours on end or scrolling on their phones.
The rise in screen time on smartphones, laptops, and tablets means that many people spend hours in postures that strain the neck and upper back. Over time, this forward-head position places extra stress on the cervical spine and surrounding muscles, leading to pain, stiffness, and long-term postural changes.
That’s where a multidisciplinary approach makes all the difference. Chiropractic care for neck pain focuses on restoring spinal alignment and improving joint mobility, while physical therapy targets muscle imbalances and retrains movement patterns. Together, these treatments don’t just address pain – they correct the root of the problem and help prevent flare-ups in the future. In our Smithtown office, every patient benefits from this team-based approach, whether they come in with tech neck, sports injuries, or everyday aches and pains.
Table of Contents
What is Tech Neck?
Tech neck refers to a repetitive strain injury caused by forward head posture (FHP) — a position in which the head protrudes forward from the body’s centerline. This posture significantly increases the mechanical load on the cervical spine. Studies show that every inch of forward head movement increases the weight of the head on the spine by 10 pounds (Hansraj, 2014). And since most peoples’ domes weigh 10-12 pounds to begin with, this is a pretty significant amount of added strain that can lead to the following:
- Cervical (neck) pain and stiffness
- Upper back and shoulder discomfort
- Headaches
- Reduced range of motion
- Degenerative spinal changes over time
Contributors to tech neck include poor ergonomics, prolonged screen time, and lack of postural awareness.
Multi-disciplinary Approach To Prevent and Fix Tech Neck
Chiropractic Care
Chiropractic care emphasizes the relationship between spinal alignment and nervous system function. For tech neck, chiropractors focus on correcting vertebral subluxations (misalignments) and restoring proper spinal biomechanics. Since most of the patients with tech neck syndrome come to us complaining of pain in the cervical area, chiropractic care for neck pain is one of the first treatments that you will experience in our office to help relieve symptoms and restore proper alignment of the cervical spine.
Spinal Manipulation and Mobilization
Chiropractors often use spinal manipulation to improve joint mobility and reduce nerve irritation. High-velocity, low-amplitude (HVLA) thrusts are applied to cervical and thoracic regions to restore movement and reduce pain.
Evidence Support
Studies show that joint mobilization of the cervical and thoracic spine can significantly improve posture and reduce pain in people with forward head posture. One trial found that combining mobilization with exercise led to better outcomes than exercise alone (Cho et al., 2017). Another showed that mobilizing the cervicothoracic junction produced greater gains in posture and mobility than upper cervical techniques (Kim et al., 2021).
Postural Assessments and Ergonomics
Our chiropractors assess posture using physical examination. Patient education includes advice on ergonomics, such as screen height and chair support.
Soft Tissue Techniques
Manual therapies such as myofascial release, instrument assisted myofascial release, cupping and trigger point therapy are used to address muscular tightness by recreating the healing process-especially but not limited to the trapezius, levator scapulae, and suboccipital muscles.
Evidence support
A 2021 study found that instrument-assisted soft tissue mobilization (IASTM) with exercise improved posture, neck mobility, and disability scores more than traditional massage (Mylonas et al., 2021). This suggests that targeted therapies paired with corrective exercises are more effective than general massage for managing tech neck.
Physical Therapy Approach to Tech Neck
Physical therapists take a movement-based approach to correcting the muscular and postural imbalances contributing to tech neck. Thankfully all the chiropractors at our office also address tech neck from the physical therapy standpoint.
Strengthening and Stretching Exercises
- Strengthening: Muscle testing will focus on the superficial and deep cervical flexors, cervical extensors, scapular stabilizers, thoracic extensors and the musculature of the anterior chest wall.
- Stretching: Targets anterior structures, including pectoralis major/minor and sternocleidomastoid. However, once muscles that were once weak strengthen, they no longer remain tight and the need to stretch is greatly reduced. But we have no problem with people taking regular breaks to stand up and stretch out.
Evidence Support
A 2023 randomized controlled trial in Healthcare compared different exercise programs for university students with forward head posture and found that both corrective exercise and stretching led to significant improvements (Sung et al., 2023). See, what we do really works!
Functional Movement and Ergonomics
Patients are trained in proper ergonomic setups for workstations and handheld device use, including exercises like chin tucks, wall angels, and thoracic extension drills. Our patients are always sent home with corrective exercises in order to relearn how to use their muscles properly.
Evidence Support
A 2020 clinical trial in the Journal of Family Medicine and Primary Care found that deep cervical flexor training improved forward head posture and reduced neck pain in adolescents who spent significant time on computers (Sikka et al., 2020). This shows that targeted exercises make a real difference!
Here are a few of the “homework” exercises that we usually prescribe to the patients if we identify the tech neck posture.
Integrative Care and Prevention
An integrative approach that combines chiropractic and physical therapy can be particularly effective. Chiropractic adjustments can quickly reduce pain and improve joint function, while physical therapy addresses long-term muscular and postural imbalances. Preventative strategies include:
- Regular movement breaks during screen use
- Ergonomically optimized workstations
- Consistent exercise targeting postural muscles
- Awareness and education on proper device use
Evidence support
A 2021 randomized controlled trial in the International Journal of Environmental Research and Public Health found that combining manual therapy with targeted exercise significantly improved forward head posture, reduced neck pain, and enhanced function in adolescents who spent long hours on computers (Kang et al., 2021). Manual therapies—such as chiropractic adjustments, joint mobilization and soft tissue work—help restore proper movement and reduce muscle tension, while corrective exercises retrain posture. Together, these approaches create a powerful foundation for relieving tech neck and preventing it from coming back.
Case Study: Tech Neck in a College Student
One of my most recent tech neck cases was a college student home on break. They came in complaining that the right side of their neck down to the inside border of their shoulder blade was constantly aching. It had started during the school year but had gotten worse now that they were home. Not surprisingly, they admitted to being on their phone all the time.
Visit 1:
On exam, their scalenes, bilateral levator scaps and the bilateral upper traps were tight and tender. I treated those muscles with instrument-assisted myofascial release and did a cervical and thoracic adjustment. It was their very first adjustment—and honestly, I think it was life-changing for them. The right scalenes also tested weak, so I sent them home with some strengthening exercises.
Visit 2:
They came back saying they felt about 40% better. On further testing, I found weakness in their rhomboid and lat, so I repeated the initial treatment and added work on the rhomboid, rotator cuff, lat, and serratus anterior. I also gave them a theraband and showed them scapular retraction and lat strengthening exercises to do at home.
Visit 3:
There was supposed to be a third visit, but they never needed it.
The Outcome:
After doing the new set of exercises, their pain was gone. Honestly, I love when this happens. Some might think it’s bad for business when a patient cancels because they feel good, but I see it as proof that the treatment worked. At the end of the day, I’d rather be a good doctor than a “good” businessperson – and this case was a big win.
Conclusion
Tech neck is a modern musculoskeletal disorder rooted in digital lifestyles and poor posture. Both chiropractic and physical therapy offer unique but complementary approaches to its treatment. Chiropractic care focuses on realignment and spinal mobility, while physical therapy addresses muscular endurance, flexibility, and functional posture. Together, they provide a comprehensive, non-invasive solution for managing and preventing tech neck in today’s digital age. And how awesome is it that you can find doctors that do it all at TSC? One stop shopping.
References:
- Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 25, 277–279. https://pubmed.ncbi.nlm.nih.gov/25393825/
- Sikka, I., Yadav, S. L., Tomar, S., & Yadav, R. K. (2020). Effect of deep cervical flexor training on forward head posture, neck pain, and functional status in adolescents using computers regularly: A pre-test/post-test experimental design. Journal of Family Medicine and Primary Care, 9(10), 5420–5425. https://pubmed.ncbi.nlm.nih.gov/33083487/
- Kang, J.-I., Jeong, D.-K., & Choi, H. (2021). Effect of deep cervical flexor training on forward head posture, neck pain, and functional status in adolescents using computers regularly: A randomized controlled trial. International Journal of Environmental Research and Public Health, 18(21), 11232. https://pmc.ncbi.nlm.nih.gov/articles/PMC8584283/
- Sung, Y.-H., Kwon, O.-S., & Choi, Y.-S. (2023). Comparison of exercise interventions for forward head posture in university students: A randomized controlled trial. Healthcare, 11(19), 2604. https://pmc.ncbi.nlm.nih.gov/articles/PMC10572307/
- Cho, J., Lee, E., & Lee, S. (2019). Upper cervical and upper thoracic spine mobilization versus deep cervical flexors exercise in individuals with forward head posture: A randomized clinical trial investigating their effectiveness. Journal of Back and Musculoskeletal Rehabilitation, 32(4), 595–602. https://pubmed.ncbi.nlm.nih.gov/30584118/
- Mylonas, K., Angelopoulos, P., Billis, E., Tsepis, E., & Fousekis, K. (2021). Combining targeted instrument‑assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve functionality of patients with mechanical neck pain: A randomized control study. BMC Musculoskeletal Disorders, 22(1), 212. https://pubmed.ncbi.nlm.nih.gov/33612123/
- Ghan, G. M., & Sarath Babu, V. (2021). Immediate effect of cervico‑thoracic mobilization on deep neck flexors strength in individuals with forward head posture: A randomized controlled trial. Journal of Manual & Manipulative Therapy, 29(3), 147–157. https://pubmed.ncbi.nlm.nih.gov/33090945/
