The aim of the current study was to investigate the extent of smartphone use, possible correlation with neck pain and/or psychological impairment in office workers.
A convenience sample of 1,602 office workers who were using smartphone for prolonged periods (≥ 4 years) participated in a cross-sectional report of a cohort study, assessing demographic, abnormal symptoms of pain in the neck, physical activity, and psychological behavior characteristics. Participants were assessed using a short version of the Smartphone Addiction Scale (SAS-SV), Depression, Anxiety and Stress Scales (DASS-42) questionnaire, as well as International Physical Activity Questionnaire-Short Form (IPAQ-SF). Multiple logistic regression model was conducted to evaluate the adjusted effect of smartphone overuse on nuchal symptoms.
The prevalence of neck pain among the office workers was 30.1%. Significantly more female (33.3% vs. 24.5%) and younger (42.2 vs. 43.2 years) employees reported to have neck pain. Overall in 326 (20.3%, 95% CI: 18.4%–22.4%) of studied subjects had, SAS score ≥ 31 and ≥ 33 for male and females, respectively, and so smartphone overuse (SO) was diagnosed. The results of multiple logistic regression model revealed that those with SO were approximately 6 times more likely to have neck pain (95% CI: 4.44–8.09, P < 0.001).
Smartphone overuse in office workers significantly increases the chance of neck pain by 6 times. Hence SO has been associated with, not only somatic complaints, but also psychological distress such as anxiety, stress, and depression. This may necessitate adherence to neck-school, when smartphone use is associated with neck pain.
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Regiani Bueno G, Garcia LF, Marques Gomes Bertolini SM, Rodrigues Lucena TF (2019) The head down generation: musculoskeletal symptoms and the use of smartphones among young university students. Telemed e-Health 25:1049–1056
Shan Z, Deng G, Li J, Li Y, Zhang Y, Zhao Q (2013) Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai. PLoS ONE 8:e78109
Namwongsa S, Puntumetakul R, Neubert MS, Boucaut R (2018) Factors associated with neck disorders among university student smartphone users. Work 61:367–378
Kang J-H, Park R-Y, Lee S-J, Kim J-Y, Yoon S-R, Jung K-I (2012) The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabilit Med 36:98
Berolo S, Wells RP, Amick BC III (2011) Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: a preliminary study in a Canadian university population. Appl Ergon 42:371–378
Szeto GP, Straker L, Raine S (2002) A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Appl Ergon 33:75–84
Lau KT, Cheung KY, Chan MH, Lo KY, Chiu TTW (2010) Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Man ther 15:457–462
Burgess-Limerick R, Plooy A, Ankrum D (1998) The effect of imposed and self-selected computer monitor height on posture and gaze angle. Clin Biomech 13:584–592
Brink Y, Louw Q, Grimmer K, Jordaan E (2014) The spinal posture of computing adolescents in a real-life setting. BMC musculoskelet disord 15:212
Kwon M, Kim D-J, Cho H, Yang S (2013) The smartphone addiction scale: development and validation of a short version for adolescents. PLoS ONE 8:e83558
Kheradmand A, Amirlatifi ES, Sohrabi M-R, Meybodi AM (2019) Validation of the Persian smartphone addiction scale among Tehran university students Iran. International J High Risk Behav Addict 8(1):e81176
Lee PH, Macfarlane DJ, Lam T, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. International J Behav Nutr Phys Act 8:115
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF (2003) International physical activity questionnaire: 12-countrys reliability and validity. Med Sci Sports Exerc 35:1381–1395
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, Brien OWL, Bassett DR, Schmitz KH, Emplaincourt PO (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498–S504
Vasheghani-Farahani A, Tahmasbi M, Asheri H, Ashraf H, Nedjat S, Kordi R (2011) The persian, last 7-days, long form of the international physical activity questionnaire: translation and validation study. Asian J Sports Med 2:106
Crawford JR, Henry JD (2003) The depression anxiety stress scales (DASS): normative data and latent structure in a large non-clinical sample. Br J Clin Psychol 42:111–131
Lovibond SH, Lovibond PF (1996) Manual for the depression anxiety stress scales. Psychology Foundation of Australia, Sydney
Afzali A, Delavar A, Borjali A, Mirzamani M (2007) Psychometric properties of DASS-42 as assessed in a sample of Kermanshah High School students. J Res Behav Sci 5:81–92
Hosmer DW Jr, Lemeshow S, Sturdivant RX (2013) Applied logistic regression. Wiley, Hoboken
Hansraj KK (2014) Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int 25:277–279
Park J, Kim J, Kim J, Kim K, Kim N, Choi I, Lee S, Yim J (2015) The effects of heavy smartphone use on the cervical angle, pain threshold of neck muscles and depression. Adv Sci Technol Lett 91:12–17
Ko P-H, Hwang Y-H, Liang H-W (2016) Influence of smartphone use styles on typing performance and biomechanical exposure. Ergonomics 59:821–828
Lee H, Choi YS, Lee S, Shim E (2013) Smart pose mobile posture-aware system for lowering physical health risk of smartphone users In: CHI'13 Extended Abstracts on Human Factors in Computing Systems 2257–2266
Celik S, Celik K, Dirimese E, Tasdemir N, Arik T, Büyükkara I (2018) Determination of pain in musculoskeletal system reported by office workers and the pain risk factors. Int J Occup Med Environ Health 31:91–111
Alsalameh AM, Harisi MJ, Alduayji MA, Almutham AA, Mahmood FM (2019) Evaluating the relationship between smartphone addiction/overuse and musculoskeletal pain among medical students at Qassim university. J Fam Med Prim care 8:2953
Diepenmaat A, Van der Wal M, De Vet H, Hirasing R (2006) Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among dutch adolescents. Pediatrics 117:412–416
Chen X, O’Leary S, Johnston V (2018) Modifiable individual and work-related factors associated with neck pain in 740 office workers: a cross-sectional study. Braz J Phys Ther 22:318–327
Ye S, Jing Q, Wei C, Lu J (2017) Risk factors of non-specific neck pain and low back pain in computer-using office workers in China: a cross-sectional study. BMJ open 7:e014914
Torgén M, Swerup C (2002) Individual factors and physical work load in relation to sensory thresholds in a middle-aged general population sample. Eur J Appl Physiol 86:418–427
Miranda H, Viikari-Juntura E, Martikainen R, Takala E, Riihimäki H (2001) A prospective study of work related factors and physical exercise as predictors of shoulder pain. Occup Environ Med 58:528–534
Smetaniuk P (2014) A preliminary investigation into the prevalence and prediction of problematic cell phone use. J Behav Addict 3:41–53
Haug S, Castro RP, Kwon M, Filler A, Kowatsch T, Schaub MP (2015) Smartphone use and smartphone addiction among young people in Switzerland. J Behav Addict 4:299–307
Gao T, Xiang Y-T, Zhang H, Zhang Z, Mei S (2017) Neuroticism and quality of life: multiple mediating effects of smartphone addiction and depression. Psychiatry Res 258:457–461
Jenaro C, Flores N, Gómez-Vela M, González-Gil F, Caballo C (2007) Problematic internet and cell-phone use: psychological, behavioral, and health correlates. Addict Res Theory 15:309–320
Blozik E, Laptinskaya D, Herrmann-Lingen C, Schaefer H, Kochen MM, Himmel W, Scherer M (2009) Depression and anxiety as major determinants of neck pain: a cross-sectional study in general practice. BMC musculoskelet disord 10:13
This study has been supported by support of Tehran University of Medical Sciences (TUMS) Office workers’ Cohort TEC study; (Grant no: 36600)
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Derakhshanrad, N., Yekaninejad, M.S., Mehrdad, R. et al. Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers. Eur Spine J 30, 461–467 (2021). https://doi.org/10.1007/s00586-020-06640-z
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