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Tablet Neck™ Syndrome

Tablet Neck™ Syndrome 


Tablet Neck Syndrome is a term that I started using a number of years ago as the use of computers, hand held tablets and ”smart” phones increasingly came into use.  Tablet Neck is non-discriminatory.  It afflicts men and women equally and can be found among the population across the age spectrum.  Given that children, teens and young adults increasingly spend time playing video games and using cell phones they may be more at risk.  The older population with bi-focal and tri-focal corrective eyeglasses are also subject to increased risk of developing Tablet Neck syndrome.

Take the time to observe the posture of others as they use their cell phones, tablets and play video games.  Realize you are using similar postures, too.


Symptoms associated with Tablet Neck include but are not limited to:


  • Restricted range of motion of the head and neck
  • Painful movement of the head and neck
  • Headaches
  • Ear aches and “buzzing in ear”
  • Lack of mental focus
  • Mental fatigue
  • Blurred vision
  • Nasal Sinus congestion and discharge


These symptoms are brought on as the muscles that support and move the head and neck are exposed to constant use.  The most common abuse involves habitual downward “hanging” of the head as when staring at a small screen such as a cell phone, gaming device or tablet reader although hours of watching television can contribute.  Additional actions that can contribute to the syndrome are staring upward and craning the head forward.  See illustrations.


The physiological mechanisms that contribute to the symptoms of Table Neck include muscular hypertrophy, fascial stiffening, vascular insufficiency and myofascial trigger point activity.


Muscular hypertrophy

This refers to the thickening and increased size of muscle fibers.  When a muscle is exercised it will increase in diameter.  This is the goal of those who “pump iron” regularly.  When you habitually hold certain postures as you engage your tablet device you are lifting the weight of your head and resisting the force of gravity as you hang the head forward.  The muscles respond as if you are pumping iron.  If you hold these postures in a specific position you will develop strands of muscle fibers that can feel like ropes or cables.


Fascial stiffening

The connective tissue that surrounds each muscle fiber and bundles of muscle fibers is called fascia.  The fascial tissue is composed of elastic fibers and cells floating in a fluid matrix.  The texture of the connective tissue changes based upon the water content and metabolism of the cells.  As muscles thicken and become tighter the circulation to the tissue is reduced, nutrition delivered to the tissue is reduced and waste from cellular metabolism builds up.  It is common for the fascia to become denser under these conditions.  Consider how a the “fat” within and around a raw cut of steak will harden when refrigerated and soften as it reaches room temperature.


Vascular insufficiency

Blood vessels charged with carrying blood to and from the muscles, organs and other tissues run through the fascia.  When muscles become tight they can apply pressure squeezing and reducing the diameter of the blood vessels and reducing blood flow.  This is similar to what happens when you step on a garden hose.  When the fascia becomes stiff and thicker the blood flow through arteries, capillaries and veins is slowed.  Blood pressure can increase and the heart works harder to pump the blood.  The delivery of nutrients to the supporting tissue is reduced and the removal of waste products is compromised.  The stagnation of fluid movement results in pain sensations and stiffening of the muscle and connective tissues.


Trigger point activity can cause vascular constriction due to their effects on the autonomic nervous system which controls the diameter of the larger blood vessels.  This may compromise blood supply to muscles, organs and the brain with subtle dysfunctional effects.


Myofascial Trigger Point activity

Research pioneered by Dr. Janet Travell (Myofascial Pain and Dysfunction - The Trigger Point Manual) documented the cause and effects of myofascial trigger points, areas of exquisite tenderness that develop in a muscle (myo) and it’s surrounding fascia (fascial) tissues.  Mechanical stress caused by habitual posture when using tablet devices contributes to the development of trigger points in various muscles of the head and neck.  Trigger points send a stream of impulses through the nervous system resulting in a variety of symptoms.  Among the effects of trigger points are pain, vascular constriction (reduced blood flow) and muscle weakness.  The function of various organs is affected as are the skin, ears and nasal sinuses.  Read more about trigger points here.


Following is a listing of some of the specific muscles involved in Tablet Neck syndrome along with common trigger point effects:


Semispinalis capitis - pain in temples, 

Splenius cervicis - pain in back eye, vision 

Splenius capitis - pain at top of skull

Suboccipitals - headache centered on side of skull 


Scalenes - chest, shoulder blade, arm and finger pain and stiffness

Levator Scapula - base of the neck and shoulder pain

Sternocleidomastoid - headache, sinus congestion, earache, buzzing in the ear, vision

Para-spinal muscles (longissimus, rotatores, multifidus) - tension at base of skull


Corrective Actions

Once you realize your habitual use of tablet devices may be contributing to physical health issues you can take simple steps to change.


Pay attention to your posture when using tablet devices.  Avoid hanging your head down for prolonged periods.


Limit the use of tablet devices. 


Take regular stretch breaks. 


Get a neck massage. If you are lucky enough to have a spouse or significant other chances are they also use tablet devices and need some neck massage.  Trade massage work regularly.  If convenient, make an appointment for a professional massage and ask for them to concentrate on your neck and back muscles. 


Give yourself a neck massage.  There are posts on this website giving tips on effective massage techniques. 


Neck massage tips

I use tablet devices (I am using one right now) and have fallen prey to the overuse of my neck muscles.  I have adopted a habit of massaging my neck and head muscles once a week.  Here are some tips I have found very effective in relieving the muscle tension.


Place the head and neck in a position that takes all the work off the neck muscles.  For me, laying in bed in the morning with my head supported by a pillow works well.  I alternate position to be on my back and then on each side.  During the the, resting the head on the back of a well padded chair or recliner works well.  The key is to provide adequate support to the head and neck so the muscles do not have to do any work to resist gravity.


When on my side I reach around and work on the muscles closest to the mattress surface since they will be in their most slackened position.  I pinch the sternocleidomastoid muscle between my thumb and fingers and roll the muscle between them.  I start with gentle pressure and increase the pressure as I focus in on the tightest bands of muscle fibers.  


Next I reach around to the back of the neck and press in with my fingers to get to the muscles running along the back of the neck.  The fingertips penetrate deep enough to feel for tense tissue.  I work across the fiber direction and then along the fibers to spread and lengthen them.  


I press along the lower border of the skull with my thumb to access the suboccipital muscles.