“Mobile phone addicts” and “head-down tribes”, be careful of cervical spondylosis!

Author: Zang Fazhi, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital)

Zhang Ying, Deputy Chief Physician, Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital)

Chen Huajiang, Chief Physician, Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital)

Reviewer: Yuan Wen, Chief Physician, Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital)

With the increasing popularity and usage of mobile phones, many people have unconsciously joined the "head-down tribe". Over time, neck and shoulder pains have come to them. To avoid neck and shoulder pains, you must "hold your head high and be a man". But it is unrealistic to not use your mobile phone at all. Family and friends need to be contacted, and even work meetings have been moved to "WeChat groups". What should I do?

1. What is the connection between cell phone use and neck and shoulder pain?

Most mobile phone users experience varying degrees of neck discomfort. A study of 2,438 young people with neck and shoulder pain found that 52.9% of them overused mobile phones. Cervical spine MRI also found that those who overused mobile phones had significantly more severe cervical degeneration [1]. There is even a term called "mobile phone neck", which shows that the impact of mobile phones on cervical spine health has become a hot issue.

Figure 1 Copyright image, no permission to reprint

The neck and shoulder muscles play a vital role in protecting the curvature of the cervical spine. The normal curvature of the cervical spine is a slightly convex arc, but now many young people, especially office white-collar workers who use mobile phones and computers for a long time, often find that the "cervical curvature has become straight" during physical examinations. The main reason is that they work at their desks with their heads down for a long time, look at computers, and play with mobile phones. The neck muscles are in a state of fatigue for a long time, which is prone to stubborn neck and shoulder pain. Long-term flexion of the cervical spine will cause the cervical lordosis to disappear, become straight, or even reverse. If it continues to develop, it is very easy to suffer from cervical spondylosis!

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2. Diagnosis and classification of cervical spondylosis

Some people may ask: If my neck hurts from looking at my phone too much, does that mean I have cervical spondylosis? To answer this question, we must first understand the definition of cervical spondylosis. Cervical spondylosis refers to "a disease characterized by degenerative changes in the cervical intervertebral disc and the subsequent pathological changes in the adjacent structures, which affect the surrounding tissue structures (nerves, blood vessels, etc.) and present clinical manifestations corresponding to imaging changes" [2]. In other words, if there is only neck and shoulder pain but no structural abnormalities such as aging and degeneration of the cervical intervertebral disc, cervical spondylosis cannot be diagnosed.

Cervical spondylosis is divided into cervical type cervical spondylosis, radiculopathy, spinal cord cervical spondylosis, and other types of cervical spondylosis. Cervical type cervical spondylosis, as the name suggests, is cervical spondylosis with neck discomfort as the main symptom. Radiculopathy is caused by cervical disc herniation or osteophyte hyperplasia, which compresses the nerve roots running from the cervical spine to the arms, causing arm pain and numbness. Spinal cord cervical spondylosis is a more serious type of cervical spondylosis, and the main manifestations are numbness of the limbs, unsteady walking, etc., and severe cases may even lead to paralysis. Other types of cervical spondylosis include vertebral artery type and sympathetic cervical spondylosis, which can manifest as dizziness, blurred vision, tinnitus and other symptoms, and need to be differentiated from neurological and ENT diseases for diagnosis.

In the early stages of cervical spondylosis, the main symptom is neck and shoulder discomfort. Appropriate exercise and lifestyle changes, combined with necessary physical therapy and medication, can achieve good therapeutic effects. However, if the condition continues to worsen and develops into radiculopathy or even myelopathy, surgical treatment is required.

3. How to avoid the harm to the cervical spine caused by looking down at the phone

To avoid the harm to the cervical spine caused by looking down at the phone, the focus is on the neck posture. Try to hold the phone close to the eye level and reduce the degree of bowing when looking at the phone. You can also adopt the "Ultraman-style" posture of looking at the phone, with the arm holding the phone vertical, and the other arm hugged to the chest to support the arm holding the phone, to relieve arm fatigue. When sitting at a table to look at the phone, it is also recommended to raise the phone, try to keep the neck upright, and look at the phone horizontally; or use a mobile phone holder, which is labor-saving and practical. Place the mobile phone holder on the desk to avoid looking down at the phone when it is flat on the table; you can also set a reminder for the phone usage time to avoid being addicted to it for too long.

Figure 3 Copyright image, no permission to reprint

If you have been using your phone for a long time, take some time to exercise your neck muscles. Sit upright, cross your hands and place your fingers behind your neck, stretch your arms back and straighten them, and at the same time try to look up, tighten the muscles at the back of your neck and shoulder blades, hold for 10 seconds and then relax, repeat the action, exercise several times, relax your neck muscles, relieve cervical fatigue, and effectively prevent the straightening of the cervical curvature caused by bad posture or even the occurrence of cervical spondylosis.

References:

1.ZHANG L, WANG L, XU D, et al. Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain[J]. J Orthop Sci, 2021,26(1):110-115.

2. Chinese Journal of Surgery Editorial Department. Expert consensus on classification, diagnosis and non-surgical treatment of cervical spondylosis (2018)[J]. Chinese Journal of Surgery, 2018, 56(6): 401-402.