Posture during smartphone use is an important factor that affects musculoskeletal pain.
Objective
To investigate the prevalence and characteristics of musculoskeletal pain in the neck, trunk, and upper extremities during smartphone use.
Methods
A total of 326 Chinese and Korean smartphone users participated in an online survey on smartphone posture, addiction, and musculoskeletal pain.
Results
The neck, shoulder, and lower back were most frequently affected, whereas the elbow, lower back, and forearm showed the highest level of discomfort. Stiffness was the predominant type of discomfort in most body parts. Numbness surpassed stiffness in the elbow and hand, whereas throbbing surpassed stiffness in the wrist. Body posture influenced upper arm and lower back discomfort, with a right-sided lying posture resulting in the highest level of lower back pain (p < 0.05). Using a smartphone with a more flexed neck posture increased neck discomfort (p < 0.05). Holding a smartphone with one hand, while controlling the screen with the opposite finger, increased hand pain (p < 0.05).
Conclusion
The inferences obtained from this study indicate that smartphone usage posture significantly affects musculoskeletal discomfort. The suggested posture for minimizing musculoskeletal discomfort is to use the smartphone in a left-side-lying position, hold it vertically with both hands, and utilize both thumbs for texting and scrolling.
Ericsson [Internet]. Number of smartphone mobile network subscriptions worldwide from 2016 to 2022, with forecasts from 2023 to 2028. 2022.
2.
MustafaogluRYasaciZZirekE, et al.The relationship between smartphone addiction and musculoskeletal pain prevalence among young population: a cross-sectional study. Korean J Pain2021; 34: 72–81.
3.
RatanZAParrishAMZamanSB, et al.Smartphone addiction and associated health outcomes in adult populations: A systematic review. Int J Env Res Pub Health2021; 18: 12257.
4.
RandjelovicPStojiljkovicNRadulovicN, et al.Problematic smartphone use, screen time and chronotype correlations in university students. Eur Addict Res2021 Jan 1; 27: 67–74.
5.
DemirYPSümerMM. Effects of smartphone overuse on headache, sleep and quality of life in migraine patients. Neurosciences2019 Apr 1; 24: 115–121.
6.
GuoNWangMPLukTT, et al.The association of problematic smartphone use with family well-being mediated by family communication in Chinese adults: a population-based study. J Behav Addict2019; 8: 412–419.
7.
ZhangMXWuAMS. Effects of smartphone addiction on sleep quality among Chinese university students: the mediating role of self-regulation and bedtime procrastination. Addict Behav2020 Dec; 1: 111.
8.
KayaFBostanci DaştanNDurarE. Smart phone usage, sleep quality and depression in university students. Int J Soc Psychiatry2021 Aug 1; 67: 407–414.
9.
ÖzdilKÇatıkerABulucu BüyüksoyGD. Smartphone addiction and perceived pain among nursing students: a cross-sectional study. Psychol Health Med2022; 27: 2246–2260.
10.
ZirekEMustafaogluRYasaciZ,et al.A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage. Musculoskelet Sci Pract2020; 49: 102196.
11.
DerakhshanradNYekaninejadMSMehrdadR,et al.Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers. European Spine J2021 Feb 1; 30: 461–467.
12.
AdesolaCODorcasAOOluwagbohunmiA, et al.Musculoskeletal pain and postural abnormalities among smartphone-using digital natives. J Musculoskelet Disord Treat2020 Dec 31; 6: 1–12.
13.
TaoDYangKZhangT,et al.Typing with mobile devices: A comparison of upper limb and shoulder muscle activities, typing performance and perceived workload under varied body postures, typing styles and device types. Appl Ergon2022 Jul 1; 102: 103760.
14.
Jacquier-BretJGorceP. Effect of day time on smartphone use posture and related musculoskeletal disorders risk: a survey among university students. BMC Musculoskelet Disord2023 Dec 1; 24: 725.
15.
TangZJinXWuY, et al.Ergonomic evaluation of the effects of forearm conditions and body postures on trapezius muscle activity during smartphone texting. Int J Ind Ergon2021 Mar 1; 82: 103085.
16.
MadardamUVeerasakulSTamrinSBM,et al.The effect of laying down posture while using smartphone among School Children in Nakhon Si Thammarat, Thailand. Roczniki Panstwowego Zakladu Higieny / Annals of the National Institute of Hygiene2022; 73: 221–229.
17.
SzetoGPYTsangSMHDaiJ,et al. A field study on spinal postures and postural variations during smartphone use among university students. Appl Ergon2020 Oct 1; 88: 103183.
18.
KietrysDMGergMJDropkinJ,et al.Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting. Appl Ergon2015 Sep 1; 50: 98–104.
19.
KoPHHwangYHLiangHW. Influence of smartphone use styles on typing performance and biomechanical exposure. Ergonomics2016; 59: 821–828.
20.
ZimbaOGasparyanAY. Designing, conducting, and reporting survey studies: A primer for researchers. J Korean Med Sci2023; 38: e403.
21.
KwonMKimDJChoH,et al.The smartphone addiction scale: Development and validation of a short version for adolescents. PLoS One2013 Dec 31; 8: e83558.
22.
DamascenoGMFerreiraASNogueiraLAC, et al.Text neck and neck pain in 18–21-year-old young adults. European Spine J2018 Jun 1; 27: 1249–1254.
ShariatAClelandJADanaeeM, et al.Effects of stretching exercise training and ergonomic modifications on musculoskeletal discomforts of office workers: a randomized controlled trial. Braz J Phys Ther2018 Mar 1; 22: 144–153.
26.
VillanuevaARabal-PelayJBerzosaC, et al.Effect of a long exercise program in the reduction of musculoskeletal discomfort in office workers. Int J Environ Res Public Health2020 Dec 1; 17: 1–10.
27.
TunaREskin BacaksizFKahramanB. The relationship between musculoskeletal discomfort and professional quality of life among nurses. Pain Manag Nurs2022 Feb 1; 23: 62–67.
28.
EyvazlouMAsghariAMokaramiH, et al.Musculoskeletal disorders and selecting an appropriate tool for ergonomic risk assessment in the dental profession. Work2021; 68: 1239–1248.
29.
ErdinçOÖzkayaM. Cross-cultural adaptation, validity and reliability of Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) in Turkish Language Kubilay Hot.
30.
WangYKimYJMoonKA, et al.Exploring the relation of smartphone addiction and musculoskeletal pain in the neck, trunk, and upper limbs: a cross-sectional study. Phy Ther Korea2023 Aug 20; 30: 211–220.
31.
AdachiGOshikawaTAkuzawaH,et al.Differences in the activity of the shoulder girdle and lower back muscles owing to postural alteration while using a smartphone. J Med Invest2020; 67: 274–279.
32.
EitivipartACViriyarojanakulSRedheadL. Musculoskeletal disorder and pain associated with smartphone use: A systematic review of biomechanical evidence. Hong Kong Physiother J2018; 38: 77–90.
33.
ThorburnEPopeRWangS. Musculoskeletal symptoms among adult smartphone and tablet device users: a retrospective study. Arch Physiother2021; 11: 1–13.
34.
SharanDMohandossMRanganathanR,et al.Musculoskeletal disorders of the upper extremities due to extensive usage of hand held devices. Ann Occup Environ Med2014 Aug 6; 26: 1–4.
35.
GonçalvesAdSCarmoVdAraújoLMC,et al.Uso de smartphones como fator de risco para o desenvolvimento de morbidades no punho e nos dedos. Rev Bras Ortop (Sao Paulo)2023; 58: 457–462.
36.
FuGZenggenRLiL, et al.Effects of lying posture and task type on muscle fatigue, visual fatigue, and discomfort while using a smartphone on the bed. Work2023; 76: 691–705.
37.
IkematsuKOshimaHEardleyR,et al.Investigating how smartphone movement is affected by lying down body posture. Proc ACM Hum Comput Interact2020; 4: 1–17.
38.
AlibertiSInvernizziPLScuratiR,et al.Posture and skeletal muscle disorders of the neck due to the use of smartphones. J Hum Sport Exer2020; 15: S586–S598.
39.
ParkJHKangSYLeeSG,et al.The effects of smart phone gaming duration on muscle activation and spinal posture: pilot study. Physiother Theory Pract2017 Aug 3; 33: 661–669.
40.
TapanyaWPuntumetakulRSwangnetr NeubertM,et al.Influence of neck flexion angle on gravitational moment and neck muscle activity when using a smartphone while standing. Ergonomics2021; 64: 900–911.
41.
NamwongsaSPuntumetakulRNeubertMS,et al.Effect of neck flexion angles on neck muscle activity among smartphone users with and without neck pain. Ergonomics2019; 62: 1524–1533.
42.
LiangHWHwangYH. Mobile phone use behaviors and postures on public transportation systems. PLoS One2016; 11: e0148419.
43.
YoonWChoiSHanH,et al.Neck muscular load when using a smartphone while sitting, standing, and walking. Hum Factors2021; 63: 868–879.
44.
TrudeauMBAsakawaDSJindrichDL,et al.Two-handed grip on a mobile phone affords greater thumb motor performance, decreased variability, and a more extended thumb posture than a one-handed grip. Appl Ergon2016; 52: 24–28.
45.
LeeMHongYLeeS, et al.The effects of smartphone use on upper extremity muscle activity and pain threshold. J Phys Ther Sci2015; 27: 1743–1745.
46.
AmjadFFarooqMNBatoolR,et al.Frequency of wrist pain and its associated risk factors in students using mobile phones. Pak J Med Sci2020; 36: 746.
