From the Guidelines
Tech neck is characterized by clinical findings including neck pain and stiffness, headaches, reduced cervical range of motion, forward head posture, upper back pain, shoulder pain and tightness, radiating pain, numbness, or tingling in the arms and hands, and visual symptoms like eye strain and blurred vision, as a result of prolonged forward head posture while using electronic devices. These findings are consistent with the increased mechanical stress on the cervical spine, which can lead to muscle fatigue, ligament strain, and potential disc issues over time 1. The clinical presentation of tech neck may resemble that of cervical radiculopathy, which is defined as a syndrome of pain or sensorimotor deficits due to dysfunction of a cervical spinal nerve, the roots of the nerve, or both 1.
Key Clinical Findings
- Neck pain and stiffness, particularly in the cervical spine and trapezius muscles
- Headaches that often originate at the base of the skull
- Reduced cervical range of motion, especially in extension
- Forward head posture where the ears align ahead of the shoulders rather than directly above them
- Upper back pain between the shoulder blades
- Shoulder pain and tightness
- Radiating pain, numbness, or tingling in the arms and hands due to nerve compression
- Temporomandibular joint (TMJ) dysfunction as a secondary effect
- Visual symptoms like eye strain and blurred vision
Diagnostic Considerations
In the absence of red flag symptoms, imaging may not be required at the time of initial presentation 1. Red flag symptoms for cervical and neck pain include trauma, malignancy, prior neck surgery, spinal cord injury, systemic diseases, and suspected infection 1. A recent meta-analysis assessing the positive predictive value of physical examination tests in the setting of a clinical history of cervical radiculopathy concluded that there was limited evidence for a correlation between physical examination findings and MRI evidence of cervical nerve root compression 1.
Management
Most cases of acute cervical neck pain with radicular symptoms resolve spontaneously or with conservative treatment measures 1. Therefore, conservative management, including physical therapy, pain management, and lifestyle modifications, should be the initial approach for patients with tech neck, unless red flag symptoms are present.
From the Research
Clinical Findings of Tech Neck
Tech neck, also known as cervical radiculopathy, is a condition that results from irritation and/or compression of nerve root as it exits the cervical spine 2. The clinical findings of tech neck may include:
- Pain in the neck and/or arm
- Motor or sensory deficits in areas innervated by the affected nerve root
- Limited range of motion in the neck
- Muscle weakness or spasms
Diagnosis and Treatment
Diagnosis of tech neck is suggested by history and corresponding physical examination findings, and confirmation is achieved with MRI 2. Treatment of tech neck may involve a multimodal approach, including:
- Medications to alleviate symptoms and manage pain
- Physical therapy and manipulation to improve neck discomfort
- Guided corticosteroid injections and selected nerve blocks to control nerve root pain
- Cervical epidural steroid injections (CESIs) to reduce pain and disability 3, 4, 5
Cervical Epidural Steroid Injections (CESIs)
CESIs are an accepted treatment for neck pain with a radicular component, and may be accomplished by using either transforaminal or interlaminar approaches 3. The evidence suggests that CESIs are effective for the short-term treatment of radicular pain, and may also reduce long-term disability 4, 5. However, the evidence is limited, and more rigorously designed clinical outcomes studies are needed to fully understand the effectiveness of CESIs for tech neck.