Text neck syndrome and early cervical spondylosis among young Sudanese adults: a cross-sectional study of digital device use, postural habits and neurological symptoms
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263086Keywords:
Cervical spondylosis, Forward head posture, Neck pain, Smartphone use, Sudan, Text neck syndromeAbstract
Background: Text neck syndrome and early cervical spondylosis are increasingly prevalent among young adults due to prolonged electronic device usage and inadequate postural practices. This study examined the burden of text neck syndrome and its association with digital device use, posture, and neurological symptoms among young Sudanese people.
Methods: A descriptive cross-sectional hospital-based study was conducted at the Neurology Clinic of Prince Digna Referral Hospital, Sudan, between November 2024 and January 2025. A total of 174 participants aged 17–63 years were recruited using convenience sampling. Data were collected using a structured interviewer-administered questionnaire and clinical assessment. Statistical analysis was performed using SPSS version 26.
Results: The median age of participants was 34 years (IQR: 28-42 years), and 50.6% were females. Prolonged screen exposure exceeding 6 hours/day was reported by 69.5%, while 96.6% adopted forward head posture during device use. Neck pain and neck stiffness were reported by 99.4% and 97.1% of participants, respectively. Neurological symptoms included upper-limb numbness (43.7%) and weakness (24.1%). Daily screen time demonstrated a weak positive correlation with neck pain severity (rs=0.23, p=0.002). Prolonged screen exposure independently predicted severe cervical symptoms (AOR=4.21, 95% CI: 2.01-8.83, p<0.001). Receiver operating characteristic analysis demonstrated good predictive performance for screen exposure duration (AUC=0.81).
Conclusions: Text neck syndrome symptoms and manifestations suggestive of early cervical spondylosis represent a substantial clinical burden among Sudanese adults and are associated with prolonged screen exposure, forward head posture, and poor ergonomic awareness.
References
Xiong W, Li F, Guan H. Tetraplegia after thyroidectomy in a patient with cervical spondylosis: a case report and literature review. Medicine (Baltimore). 2015 Feb;94(6):e524. doi: 10.1097/MD.0000000000000524. PMID: 25674751; PMCID: PMC4602764.
Liang S, Yang F, Zhang Y, Zhao H, Wang X. Changes and clinical correlation of diffusion tensor imaging parameters of compressed spinal cord and nerve root in patients with cervical spondylosis. BMC Med Imaging. 2022 Jun 3;22(1):107. doi: 10.1186/s12880-022-00835-0. PMID: 35659198; PMCID: PMC9166510.
Theodore N. Degenerative cervical spondylosis. N Engl J Med. 2020;383(2):159–168. doi:10.1056/NEJMra2003558.
Walker CT, Bonney PA, Martirosyan NL, Theodore N. Genetics Underlying an Individualized Approach to Adult Spinal Disorders. Front Surg. 2016 Nov 22;3:61. doi: 10.3389/fsurg.2016.00061. PMID: 27921035; PMCID: PMC5118450.
Hakami I, Sherwani A, Hadadi M, Alzahrani R, Albukhari A, Omar Y, Alsaedi K, Aljadani F, Ali N, Khan M, Alasmari R, Khan A, Aleqbali W, Hadadi R, Natto G. Assessing the Impact of Smartphone Use on Neck Pain and Related Symptoms Among Residents in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus. 2024 Jul 11;16(7):e64299. doi: 10.7759/cureus.64299. PMID: 39130843; PMCID: PMC11316211.
Piruta J, Kułak W. Physiotherapy in text neck syndrome: a scoping review of current evidence and future directions. J Clin Med. 2025;14(4):1386. doi:10.3390/jcm14041386.
Minghelli B. Adolescent neck pain: association with the use of mobile telephone. Ann Med. 2021 Sep 28;53(Suppl 1):S174. doi: 10.1080/07853890.2021.1896436. PMCID: PMC8480778.
Liu Y, Zhang YH, Lim HW. Effects of smartphone use in various floor sitting positions on spinal and pelvic alignment and gluteal pressure in healthy adults. J Phys Ther Sci. 2025 Jun;37(6):240-244. doi: 10.1589/jpts.37.240. Epub 2025 Jun 1. PMID: 40511313; PMCID: PMC12153249.
Ha SY, Sung YH. A temporary forward head posture decreases function of cervical proprioception. J Exerc Rehabil. 2020 Apr 28;16(2):168-174. doi: 10.12965/jer.2040106.053. PMID: 32509702; PMCID: PMC7248444.
Reddy RS, Tedla JS, Dixit S, Abohashrh M. Cervical proprioception and its relationship with neck pain intensity in subjects with cervical spondylosis. BMC Musculoskelet Disord. 2019 Oct 15;20(1):447. doi: 10.1186/s12891-019-2846-z. PMID: 31615495; PMCID: PMC6794723.
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 Aug 29;14(1):20116. doi: 10.1038/s41598-024-71153-4. PMID: 39209955; PMCID: PMC11362573.
Phuyal N, Pandey N, Pandeya A, et al. Smartphone overuse and its impact on musculoskeletal pain in the neck and wrists/hands in medical and nursing undergraduate students: a cross-sectional study. Sci Rep. 2025;15:44945. doi:10.1038/s41598-025-29317-3.
Barzegari S, AllahVerdi M, Valian F, et al. Prevalence of text neck syndrome among university students: systematic review and meta-analysis. J Public Health (Berl). 2025. doi:10.1007/s10389-025-02565-3.
Zhuang L, Wang L, Xu D, Wang Z, Liang R. Association between excessive smartphone use and cervical disc degeneration in young patients suffering from chronic neck pain. J Orthop Sci. 2021;26(1):110–115. doi:10.1016/j.jos.2020.02.009.
Lv Y, Tian W, Chen D, Liu Y, Wang L, Duan F. The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults: a community-based cross-sectional study. BMC Musculoskelet Disord. 2018 Sep 11;19(1):325. doi: 10.1186/s12891-018-2234-0. PMID: 30205836; PMCID: PMC6134586.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for pain (VAS Pain), Numeric Rating Scale for pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240–52. doi:10.1002/acr.20543.
Downloads
Published
How to Cite
Issue
Section
