Neck pain related to cellphone use among secondary-level students
DOI:
https://doi.org/10.5281/zenodo.22759995Keywords:
neck pain, cellphone, text neck syndrome, adolescentsAbstract
Introduction: Excessive cellphone use has been identified as a growing public health problem, associated with neck pain and so-called text neck, particularly in adolescents with high digital exposure. The aim was to determine the relationship between cellphone use time and neck pain among secondary-level students at Colegio Santa Rita de Casia, Capiatá, Paraguay, during 2025.
Materials and methods: Correlational, non-experimental quantitative study. Online self-administered questionnaire including the Standardized Nordic Questionnaire (SNQ) and the Smartphone Addiction Scale (SAS). Convenience sampling; n = 100.
Results: Age 16–17 years 70%; male 52%, female 48%. Recreational use ≥3 h/day 62% (>5 h 25%). Neck problems in 12 months 37%; of these, 60% with impairment of normal activities. Problematic use: constantly checks social networks 49%; uses more time than intended 42%; considers self addicted 10%.
Conclusions: High-risk use patterns and a clinically significant prevalence of neck pain coexist, with an apparent disconnect between the habit and individual perception of its consequences, supporting ergonomic and educational interventions.
References
Bottaro R, Faraci P. Psycho-physical well-being in adolescent users of social networking sites: empirical evidence for text neck syndrome and related measures. Appl Psychol Health Well Being. 2025;17(3):e70050. https://doi.org/10.1111/aphw.70050
Puvvada D, Yalavarthi YN, Manumanthu R, Pampana S, Ponamandi NL, Uddarraju SR, et al. Text neck in dental students: prevalence, ergonomic correlates and response to a brief exercise programme. Eur J Dent Educ. 2026 Jul 28. https://doi.org/10.1111/eje.70255
Yang SY, Chen MD, Huang YC, Lin CY, Chang JH. Association between smartphone use and musculoskeletal discomfort in adolescent students. J Community Health. 2017;42(3):423-430. https://doi.org/10.1007/s10900-016-0271-x
Kwon M, Lee JY, Won WY, Park JW, Min JA, Hahn C, et al. Development and validation of a smartphone addiction scale (SAS). PLoS One. 2013;8(2):e56936. https://doi.org/10.1371/journal.pone.0056936
Kwon M, Kim DJ, Cho H, Yang S. The smartphone addiction scale: development and validation of a short version for adolescents. PLoS One. 2013;8(12):e83558. https://doi.org/10.1371/journal.pone.0083558
Hawamdeh M, Al-Nassan SM, Obaidat SM, Shallan A, Hawamdeh ZM, Eilayyan O, et al. The relationship between using smartphones and text neck syndrome in online learning among university students in Jordan: a survey study. Ortop Traumatol Rehabil. 2023;25(6):315-320. https://doi.org/10.5604/01.3001.0054.2883
Ayhualem S, Alamer A, Dabi SD, Bogale KG, Abebe AB, Chala MB. Burden of neck pain and associated factors among smart phone user students in University of Gondar, Ethiopia. PLoS One. 2021;16(9):e0256794. https://doi.org/10.1371/journal.pone.0256794
Elvan A, Cevik S, Vatansever K, Erak I. The association between mobile phone usage duration, neck muscle endurance, and neck pain among university students. Sci Rep. 2024;14(1):20116. https://doi.org/10.1038/s41598-024-71153-4
Maayah MF, Nawasreh ZH, Gaowgzeh RAM, Neamatallah Z, Alfawaz SS, Alabasi UM. Neck pain associated with smartphone usage among university students. PLoS One. 2023;18(6):e0285451. https://doi.org/10.1371/journal.pone.0285451
C A, Sahayam D B. Translation and psychometric properties of the Tamil version of the Smartphone Addiction Scale-Short Version (SAS-SV-T) among adolescents: measurement invariance across gender. BMC Psychol. 2025;13(1):874. https://doi.org/10.1186/s40359-025-03153-6
Mokhtarinia HR, Torkamani MH, Farmani O, Biglarian A, Gabel CP. Smartphone addiction in children: patterns of use and musculoskeletal discomfort during the COVID-19 pandemic in Iran. BMC Pediatr. 2022;22(1):681. https://doi.org/10.1186/s12887-022-03748-7
John JN, Okonkwo UV, Ibeneme SC, Fortwengel G, Okpagu BC, Nwosu EO, et al. Smartphone addiction, nomophobia, and neck-related functional disability among undergraduate students in a Nigerian university: a cross-sectional study. BMC Public Health. 2026;26(1). https://doi.org/10.1186/s12889-026-27976-z
Chen YL, Tang WH, Guan YX. Gender-specific biomechanical effects of smartphone use with backpack load during standing and walking. Sci Rep. 2025;15(1):36091. https://doi.org/10.1038/s41598-025-20015-8
Kurtaran M. Comparison of musculoskeletal pain and upper extremity disability in smartphone addicts and smartphone non-addicts among university students: a cross-sectional study. J Bodyw Mov Ther. 2024;40:279-285. https://doi.org/10.1016/j.jbmt.2024.04.041
Shiferaw BD, Tang J, Wang Y, et al. Impact of digital addiction on youth health: a systematic review and meta-analysis. J Behav Addict. 2025;14(3):1129-1158. https://doi.org/10.1556/2006.2025.00081
Zhou Y, Gong J, Shao J, Yan N, Meng L, He K, et al. Symptom network between problematic smartphone use and poor sleep quality in adolescents with depression. BMC Psychiatry. 2025;25(1):482. https://doi.org/10.1186/s12888-025-06920-2
Yue W, Cao S, Zhao J, Wang Q, Lai W, Zhang J, Cui Y. Associations of smartphone addiction and physical activity with sleep quality and neck/shoulder symptoms in university students: a cross-sectional study. Front Public Health. 2026;14:1848640. https://doi.org/10.3389/fpubh.2026.1848640
Correia IMT, Ferreira AS, Gomes JFM, Reis FJJ, Nogueira LAC, Meziat-Filho N. Cervical flexion posture during smartphone use was not a risk factor for neck pain, but low sleep quality and insufficient levels of physical activity were. A longitudinal investigation. Braz J Phys Ther. 2025;29(6):101258. https://doi.org/10.1016/j.bjpt.2025.101258
Ashraf MA, Ghaffari M, Namdari M, Sahlabadi AS. The influence of educational intervention, according to ergonomic principles on neck and shoulder disability and pain indices relevant to smartphones, among students. J Educ Health Promot. 2025;14:503. https://doi.org/10.4103/jehp.jehp_977_24
Kannappan SR, Alva J, Dsa VB. Examining the impact of the exercise package on eye and neck strain (EPENS) among adolescents: a pre-experimental study at a selected preuniversity college in Mangalore. J Educ Health Promot. 2024;13:459. https://doi.org/10.4103/jehp.jehp_20_24
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Dahiana Edith Palmerola Ozuna, Felipe Miguel Oviedo Frutos (Autor/a)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles are distributed under the Creative Commons Attribution 4.0 International — CC BY 4.0 licence. Authors retain copyright and grant the journal the right of first publication. Any reuse must acknowledge authorship, cite the original source and indicate whether changes were made.











