Text Neck


It’s not uncommon today to walk into a room and see the majority of people looking down at their phone. Surely that can’t be doing any good for the neck and spine! As mentioned in a Forbes article, a new study by Dr. Kenneth Hashraj, The Chief of Spine Surgery at the New York Spine Surgery and Rehabilitation Medicine, discusses the effects of prolonged phone use.

The human head generally weighs between 10-12 pounds. When looking down at your phone, the spine and neck is under stress, causing extra strain, damaging your posture as well as spine. The force of the cervical spine (neck) increases as you move your neck forward at different angles. “The force increases by about 27 pounds at a 15-degree angle, 40 pounds at a 30-degree angle, 49 pounds at a 45-degree angle and 60 pounds at a 60-degree angle.” This poor posture associated with looking down at your phone is known as “text neck.”

“It is an epidemic or, at least it’s very common” mentions Dr. Hashraj in an interview with The Washington Post.

You may enjoy texting, tweeting, or talking while on your phone, but “text neck” may cause degeneration of the spine. You may be doing more harm than good, leading to spinal care much earlier on in life. “Text neck” will cause damage to the spinal tissue, causing it to stretch and making the tissue sore and inflamed.

Dr. Hashraj goes on to mention, “The ‘text neck’ effect is comparable to bending a finger all the way back and keeping it there for around an hour.” This image alone is disturbing as a picture of what is happening to the spine.

Even though it may be impossible to stop tilting your head forward while using a mobile device, there are a few options to help ease “text neck”:

  • Move your eyes instead of tilting down to look at your phone.
  • Hold your phone so it is at eye level.

Neck Pain Facts


  • The majority of neck pain isn’t caused by serious conditions, such as fracture, cancer, or inflammatory arthritis.
  • Fifty percent of all people over the age of fifty have disc herniations, arthritis, and narrowed areas, and have absolutely no pain!
  • The only time you will hurt is if a structure in the spine becomes inflamed.
  • You can achieve long term relief if you eliminate the inflammation around the disc, nerve or joint in the neck, and THEN learn how not to re-aggravate the structure.
  • Most pain in the back of the shoulder and shoulder blade area is due to an inflamed structure in the neck.
  • Eighty percent of all painful conditions of the neck are self-limited and will resolve in four to six weeks.
  • Nearly all pain going down the arm is due to a disc herniation or a narrowing of the hole where the nerve exists.
  • One of the most common side effects of neck pain is headaches.
  • If you eliminate the inflammation in the neck, the headaches will resolve.
  • An injection of steroids around the disc and nerve takes two weeks to totally work. Do not get a series of injections until you receive the full effect of the first one.

Tips for a Healthy Spine


  • Start stretching: stretching will help maintain normal joint functions and will reduce the risk of injuries.
  • Lift with your knees: you can easily damage your back if you try to lift something the wrong way. Always bend your knees and lift. One twist the wrong way can cause damage.
  • Stay active: by exercising, you can stay healthy and lose weight. Excess weight can cause pressure on muscles, tendons, and ligaments.
  • Sleep right: getting enough sleep per night is essential, as the night is when the body can repair itself. Sleeping on your side is better than on the stomach as this puts extra pressure on the spine.
  • Stay hydrated: drinking enough water will maintain soft tissue elasticity and fluidity in the joints, allowing for easier movement.
  • Work smart: try to create a work space that will have less stress on your back.
  • Don’t ignore frequent pain: it is common to experience the odd day of back pain; however, it could be a warning sign for something more serious. If back pain goes untreated, the spine can become more damaged, leading to more pain.

Back Pain Facts


  • Back pain affects 8/10 people at some point during their lives.
  • Around ¼ of US adults experience low back pain for at least 1 whole day.
  • Back pain is the most common reason for missing work.
  • Lower back pain is the single leading cause of disability worldwide.
  • The majority of back pain isn’t caused by serious conditions such as a fracture, cancer, or inflammatory arthritis.

Frequently Asked Questions – Hip pain versus back pain


1) How do you diagnose whether the pain that I have in my hip is coming from my hip or my back?

Using a continuous x-ray machine, I place an anesthetic inside of the hip joint. I then let you walk around over the next ten to fifteen minutes while the inside of the hip is numb. If you notice that your hip pain is gone, we now know that the pain was coming from the hip. If you still have pain, I know that the pain is likely coming from the lumbar spine. If the pain in the hip area is not gone, I will go ahead and put the local anesthetic and anti-inflammatory medication on the nerve in the lumbar spine that goes to the hip. If the hip pain goes away immediately after doing that, I know that the hip pain is actually coming from the lumbar spine.

2) Is it possible to have problems with both my hip and back at the same time?

Yes, it can happen, but usually when patients have this type of pain, what we find is that the majority of the pain is coming from one area. It is very important to know exactly where your pain is coming from because this will determine the therapy, exercises, and possible surgical options.

3) Will your procedures make my pain go away and for how long?

The pain will go away once we locate the exact cause of your pain. The duration of the pain relief is dependent on how severe the level of degeneration is, whether it is in the spine or the hip, and if you follow the instructions given to keep from re-aggravating your spine or hip. What you need to remember is that ALL of us are going to have degeneration in our spine as we age and luckily we will not have any pain until we get that structure inflamed. If I can eliminate the inflammation and teach you proper body mechanics and exercises to strengthen your spine, you will have a better chance of an extended period of relief.

4) Can I have the treatments repeated if necessary? Why do you not do series of injections a week apart?

These procedures can be repeated several times a year, if necessary, but we usually do not have to do this that frequently. If we can treat the exact structure and change the way the patient moves and exercises, we can usually limit the number of procedures. If we have to keep repeating the procedure, we try to see if there is a surgical fix. The good news is that since we know the exact cause of the pain, it makes the surgeon’s job so much easier.

Doing a series of injections was something we did many years ago when we did not have a continuous x-ray machine. The steroids take at least two weeks to work and, therefore, there is absolutely no reason to do a second injection before two weeks is up. If you are much better from the first injection, I would not do a second injection.

5) I see advertisements for Laser and other procedures on the television and radio. What is the difference?

You live in one of the largest and best medical centers in the country. There are a lot of very good spine and neurosurgeons in the medical center. These physicians do not do any of these laser or other “procedures” that you see advertised on the internet, television, or radio. Be careful when physicians offer multiple procedures in a short timeframe. Why not wait to see how the first procedure works, which is going to take at least a couple of weeks, before having something else done?

Several important facts: Hip or Groin Pain


Hip arthritis almost always creates pain in the groin. If you do not have groin pain, but have pain in the buttock or the side of the hip, the cause of your pain is almost always due to a herniated disc irritating a nerve or the hole where the nerve leaves the spine is narrowed and, therefore, pinching the nerve.

Pain in the groin can still come from your back. Almost all of the lumbar nerves that come from your back can create groin pain.

Pain in the buttock or side of the hip is almost always due to one of the lower lumbar nerves. You should also know that the word “sciatica” just means pain down the leg and it could be coming from the L4, L5, or S1 nerves.

My Hip Hurts – is it my back or my hip?


Hip pain is a common problem that I see on a daily basis. It can be very confusing to many people because of where they think their hip is located and where the hip creates pain when it is inflamed. The hip joint is actually located in the area of your groin and creates pain in the groin and down the thigh to the knee. It is NOT located in the buttock.

Hip pain creates pain in the groin, front of the thigh down the front of the leg to the knee, and in the area where the lower buttock meets the leg. The picture below shows the area of the buttock where you will feel pain if the pain is coming from the hip.

What you should notice in this picture is that, except for that small area that is colored red, the hip does NOT create pain in the buttock. Most of the pain that you may feel in your buttock, leg, side of hip, and even in the groin is actually created by the back. So when patients come to see me and say their “hip hurts” or they have “bursitis,” it usually means that one of their nerves from the lumbar spine is creating their pain. The picture below shows where the nerves in the back travel to after they leave the spine. As you can see, most of the lumbar nerves that come out to the spine cover what most people think is their hip. The two specific nerves that I would look at in this picture are the L4 and L5 nerves as they cover most of the areas of the hip and buttock.

Sitting Too Much Can Endanger Your Life!


At SpineCare, we advocate for less sitting for long periods of time, possibly standing up for a few minutes every thirty minutes or so because sitting is a terrible position for the spine. Sitting with the head down, which all of us do way too much, creates a lot of stress on the spine and the discs. Now a new study shows it is just plain bad for your health to sit for long periods of time! Either stand up and walk around every 30 minutes or use a standing desk.

According to the World Health Organization, one of the leading risk factors for death is something we do everyday – or don’t do! Physical inactivity comes in at 4th on this list. Sitting down could possibly lead you to a premature death.

Even though we all have busy lives, we are surrounded by activities that involve us sitting down often. To get to work, we sit, whether it’s in a car or on a bus. At work, we tend to sit the majority of the day (depending on the working environment.) We come home from a long day’s work to relax and SIT in front of the TV and unwind.

According to a CCN article, it seems even if you exercise enough, the impact of sitting still exceeds the benefits of trying to stay fit and healthy, researchers from Toronto found. A study from the Annals of Internal Medicine found that sedentary behavior (a group of behaviors occurring while sitting or lying down that requires very low energy levels) can cause chronic conditions, such as Type 2 Diabetes, as well as cause death from cancer and cardiovascular diseases.

Sitting for more than 8-12 hours a day (prolonged sitting) can increase your chances of developing Type 2 Diabetes by a whopping 90%. To overcome this, you must become more aware of how much sitting you actually do. Here are a few quick tips to help you reduce your sitting time:

  • Try using a standing desk at work.
  • Set goals to get up and walk about for a minute every 30 minutes.
  • While watching TV, instead of forwarding the commercials, take a break and walk around.
  • Take the stairs instead of the elevator.
  • Walk after you eat lunch.
  • If your co-workers are nearby, get up and talk to them rather than sending emails.