IPOH, Aug 1 — Handing a smartphone or tablet to a child has become an easy solution for many parents, whether to keep them entertained while waiting for food at restaurants, during long journeys or to stop a tantrum.

But prolonged and repeated use of smart devices can lead to unwanted consequences. Text neck syndrome, a condition once associated with adults who spend long hours working on computers, is now becoming more common among children.

Text neck syndrome occurs when the neck is repeatedly bent forward or protrudes beyond the normal shoulder alignment while using digital devices for extended periods.

According to medical experts, the condition can affect children as young as six if parents continue allowing unrestricted use of smartphones and tablets.

“One of the most common symptoms is persistent neck pain,” Ipoh Specialist Hospital consultant orthopaedic and spine surgeon Dr S. Jaya Thilak told Bernama.

Device addiction

He said text neck syndrome has become an increasingly concerning condition over the past 10 to 15 years, mirroring the rapid rise in smartphone and digital device usage.

More alarming, he said, is the growing number of cases involving children as young as six to eight years old who suffer from neck pain and stiffness after prolonged use of smart devices.

Recalling one case he handled, he said the patient was only 11 years old and had been experiencing persistent neck pain.

“The child had a history of frequent smartphone and device use, which may have contributed to the symptoms. However, other factors may have also played a role, including posture while studying, the use of tablets or computers, daily activities, neck muscle strength and physical activity level,” he explained.

Dr Jaya said device addiction is one of the key causes of the condition and that many users unknowingly maintain a head-down posture for prolonged periods because they are completely absorbed in what they are watching.

“In the past, children watched television, which naturally encouraged eye and body movement. Today, social media algorithms and video platforms are designed to keep users scrolling endlessly from one piece of content to the next, making it increasingly addictive.

“Smartphones are particularly addictive. While reading a book also involves looking down, people rarely spend hours in the same incorrect posture as they do when using their phones. Many users simply don’t realise how long they have been holding their neck in an unhealthy position,” he said.

According to Dr Jaya, using a smartphone continuously for more than 30 minutes to an hour while the neck remains bent forward is enough to significantly increase the risk of neck stiffness and postural problems.

Poor posture

He said poor posture while using smart devices places excessive strain on the neck muscles, leading to muscle tension and increasing the risk of ligament damage. In some cases, it may also accelerate the degeneration of the spinal structures.

“Many parents assume their children are only using their phones for a short while. However, the issue is not just the duration of use, but also the position of the head and neck while using the device.

“An average human head weighs about three to four kg (kilogrammes). But when the neck bends forward at an angle of around 30 degrees to look at a smartphone screen, the load on the neck can increase to between 27 and 30 kg.

“Imagine a child quietly watching their favourite videos in the living room with their head bent forward. From the outside, everything appears normal, but at that very moment, their small neck is bearing the equivalent of lifting a heavy weight continuously,” he said.

The effects, however, are rarely immediate.

According to Dr Jaya, one of the earliest signs of excessive device use is neck stiffness as prolonged poor posture causes the neck muscles to tighten and become rigid, restricting movement and causing discomfort while carrying out daily activities.

“If this continues, the problem extends beyond the muscles. It can also affect the ligaments and other structures in the neck, including the spinal joints and discs, which act as shock absorbers and allow the spine to move smoothly. Maintaining poor posture while using devices can accelerate the degeneration or ageing of these discs,” he said.

He explained that the water content within spinal discs naturally decreases with age, causing them to thin over time. However, repeated strain from poor neck posture can hasten this process, increasing the risk of pressure on the nerves and spinal disorders at a younger age.

“As the discs wear down and become thinner, they may compress the surrounding nerves, resulting in chronic neck pain, numbness and persistent discomfort.

“In certain cases, prolonged nerve compression can lead to more serious complications, including impaired nerve function,” he said, adding that the risk of permanent disability, however, remains extremely low and rarely occurs.

Correct posture 

Meanwhile, consultant orthopaedic surgeon Dr Loh Choong Sing advised smartphone users to keep their head and neck upright and hold their devices at eye level to minimise strain on the neck muscles and spine.

“When the head is held upright, the neck supports a load of only about five kg. At a 30-degree forward tilt, the load increases to around 15 kg, while at a 60-degree angle it can reach approximately 30 kg,” he said.

Dr Loh, who is Quill Ipoh Orthopaedic Hospital medical director, advised against using digital devices or working continuously at a desk for prolonged periods.

“To reduce the risk of text neck syndrome, people should take regular breaks every 30 minutes. Stand up for one to two minutes, perform light stretching exercises and gently move the neck before resuming work or screen use,” he told Bernama.

Dr Loh said lifestyle modification is the primary treatment for text neck syndrome, with physiotherapy playing an important role in strengthening the neck muscles and teaching patients proper posture.

“Physiotherapists also educate patients on correct device usage to minimise the risk of recurring symptoms. Most patients show significant improvement after undergoing treatment and adopting healthier daily habits,” he said.

Dr Jaya also said that collaboration among the Ministry of Health, Ministry of Education and Ministry of Higher Education would be valuable in supporting further research on text neck syndrome, as well as strengthening public awareness and preventive education programmes.

According to Dr Jaya, while Malaysia has yet to compile comprehensive national data on text neck syndrome, an international study found that nearly two-thirds of regular smartphone users reported neck pain, reflecting the growing musculoskeletal impact of prolonged device use. 

He added that a recent study conducted at the International Islamic University Malaysia campus in Kuantan, Pahang, also found that neck pain was common among university students and was significantly associated with smartphone addiction, highlighting the importance of promoting healthier digital habits from a young age. 

Dr Jaya also welcomed the government’s digitalisation initiatives in education, including the use of tablets in schools, and said these could be complemented by practical guidance on healthy device use, proper posture and ergonomics to help reduce the risk of neck and spinal problems.

He added that educating students, teachers and parents on safe digital device habits would play an important role in preventing text neck syndrome while supporting the country’s digital learning agenda.

“The most important thing is to ensure that the tablet or smartphone is positioned at the correct height. Students, teachers and parents must be constantly reminded about the importance of maintaining good posture while using digital devices,” he said.

He added that in Ipoh, the Ministry of Health conducts a scoliosis awareness programme in schools to educate children, teenagers and the wider community about scoliosis or spinal curvature as young people are among those most at risk.

“A similar approach could be adopted to raise awareness of text neck syndrome,” he said. — Bernama