Recognise ‘Text Neck’ Syndrome As An Occupational Disease, Says Expert

Neck pain or stiffness and watery or tired eyes are often dismissed as minor discomforts but experts warn they may be early symptoms of ‘text neck’.

A condition caused by prolonged downward tilting of the head while looking at smartphone or computer screens, text neck is a modern-day digital-age illness that is increasingly on the rise in this country.

Students and white-collar workers who spend long hours in front of their smartphones and computers are particularly susceptible to the condition, which could eventually lead to spinal injuries.

Azlan (not his real name), 34, an information technology executive here, is suffering from the condition and now has to undergo weekly physiotherapy.

“It started with just a stiff neck but over time I couldn’t turn to the left without pain. Turns out, my working posture was the main cause,” he said, adding he spends more than nine hours a day in front of his computer, not including time spent on his smartphone after office hours.

According to experts, when a person tilts their head forward at a 40-degree angle, the pressure on the spine can increase sixfold to about 12 kilogrammes, compared to the average head weight of two kilogrammes. This constant strain affects the muscles, ligaments and spinal discs.

LOW AWARENES

Countries such as the United States, South Korea and Singapore have classified text neck syndrome as a form of “modern health epidemic”.

Text neck syndrome, which is caused by excessive use of digital devices, is increasingly worrying and requires immediate action and cooperation from various parties.

In Singapore, for instance, studies have found that more than 70 percent of university students and nearly two-thirds of office employees experience symptoms associated with the syndrome.

However, in Malaysia, awareness of the condition remains low and there is no comprehensive official data. And, even though health facilities are already seeing a marked increase in cases, the nation has yet to recognise text neck as an occupational disease.

Ergonomics expert at the National Institute of Occupational Safety and Health (NIOSH) Raemy Md Zein said muscle tension, numbness, and neck and spinal pain are among the most common complaints from white-collar workers during training and audit sessions conducted by NIOSH.

Although there is a lack of official statistics on text neck, NIOSH’s field observations clearly indicate a sharp rise in issues related to prolonged static posture, especially among digital workers, students and streamers.

“Public awareness, particularly among young people, is still very low regarding the long-term risks of prolonged sitting and incorrect neck posture,” he said in an interview with Bernama.

Despite the increasing number of cases, Raemy said Malaysia is still not adequately prepared to address the issue, including in terms of officially recognising text neck as an occupational disease.

He said for now, the condition is covered under the category of musculoskeletal diseases listed in the Fifth Schedule, Part 10 of the Social Security Act 1969.

Under the Occupational Safety and Health Act 1994, the list of diseases recognised under the Occupational Safety and Health (Notifiable Occupational Diseases) Regulations 2022 (NADOPOD) is “still too limited and does not yet reflect the health challenges faced by digital workers”.

Raemy Md Zein.

“NADOPOD, which comes under the Department of Occupational Safety and Health (DOSH), functions as the official guideline for verifying occupational diseases. However, it currently does not include digital posture disorders such as text neck,” he said.

According to Raemy, without official recognition, thousands of digital and gig economy workers suffering from the condition are not able to receive proper protection.

“This is a systemic shortcoming that requires urgent attention. NIOSH believes it is time to review and update the list of occupational diseases to include ergonomic disorders like text neck, which is becoming increasingly serious,” he said.

To that end, NIOSH is currently drafting several proposals to be submitted to the relevant authorities to expand the scope of occupational diseases under the Social Security Act.

GUIDELINES

Aware that the official recognition of digital work-linked musculoskeletal disorders may take time, Raemy said early prevention is critical to managing the risks before they turn into serious health problems.

In this context, he said the 2017 Ergonomic Risk Assessment Guidelines at the Workplace, published by DOSH, can play a vital role. These guidelines offer practical directions for organisations to systematically identify, assess and control ergonomic risks in the workplace.

These guidelines are supported by NIOSH’s training programmes such as Ergonomics Trained Person (ETP) and Simplified Ergonomics Risk Assessment (SERA).

“ETP training not only produces individuals skilled in ergonomics but also helps organisations comply with legal requirements and improve worker productivity and well-being,” Raemy said, adding the ETP course is also a prerequisite for those who wish to be listed as Ergonomically Trained Persons on the official DOSH website.

The term Text Neck Syndrome is not specifically listed in the SOCSO disease catalogue, although it falls under the category of musculoskeletal diseases in the Fifth Schedule, Part 10 of the Social Security Act 1969.

The SERA programme, meanwhile, is targeted at small and medium enterprises, which usually have less exposure to ergonomic issues, especially with regard to workplace injury claims with the Social Security Organisation (SOCSO).

He also said SERA serves as an essential early intervention to help employers identify ergonomic risks in a simple and practical way.

He is also confident that through training and ergonomic risk assessments, organisations can reduce injuries and protect workers.

He also recommends that employees adopt ergonomic workplace layouts and take micro-breaks every 30 to 60 minutes.

“Computer screens should be placed at eye level, chairs must have lumbar support and keyboards should align with elbow height,” he advised.

RISING TREND AMONG THE YOUNG

Clinically, experts have observed a rising trend of young patients experiencing text neck symptoms.

Using his own experience as an example, orthopaedic consultant Dr Manmohan Singh said he is now treating more young patients for this condition than before, with this trend emerging over the past decade in line with the increased use of devices among teenagers and young adults.

“Before 2008, I rarely treated patients in their 20s for neck pain. But now, even 15-year-olds show spinal structure changes on MRI,” he said when met by Bernama.

According to the specialist from Columbia Asia Hospital Cheras here, this phenomenon, caused by drastic lifestyle changes, poses a major challenge to the healthcare system, which is not yet fully prepared to deal with the long-term impacts of digital lifestyles.

He said many patients often take early symptoms lightly – such as neck pain, watery eyes or visual fatigue – and do not realise that these can lead to serious spinal structural injuries.

He also shared the case of a 14-year-old patient who initially complained only of eye discomfort but was later diagnosed with text neck.

He noted that younger people usually seek treatment earlier because the symptoms interfere with their daily activities, while most working adults only seek help once the pain affects their sleep or job performance.

Dr Manmohan Singh.

“We’ve found that many consider neck pain to be normal… they usually just change their pillow or apply medicated oil. But when we do an MRI, we see significant changes in the spinal structure,” he said.

As for treatment options for text neck, he said most patients do not require surgery. Instead, conservative treatments such as physiotherapy and muscle-strengthening exercises, and educating them on proper posture are often more effective.

EMPLOYER RESPONSIBILITY

Dr Manmohan also stressed the importance of employers taking responsibility for their workers’ postural health by providing ergonomic workspace setups.

Inappropriate furniture and equipment, such as chairs without lumbar support or computer screens that are too low, directly contribute to chronic spinal stress, especially when used continuously without adequate breaks. This physical strain not only affects one’s health but also has a direct impact on organisational performance, he said.

Citing data from the United Kingdom’s Health and Safety Executive, he said during the 2023/24 period, the country lost 33 million working days, with 7.8 million due to issues like neck and back pain.

“If employees frequently take sick leave due to neck pain, employers should not take it lightly. Their workplace setup may not be ergonomic. Consult a doctor before the condition worsens,” he said.

Dr Manmohan also encouraged every organisation to invest in adjustable desks and spine-supportive chairs, while ensuring that computer screens are positioned at eye level. He also recommended that employees take a five-minute break to stand and do light stretches for every 45 minutes spent in front of the screen.

These small steps not only help reduce the risk of spinal injuries but also foster a healthier and more sustainable work culture, he said, adding that it is time for employers to view investments in ergonomics as a strategic necessity to ensure a healthy, productive and future-ready workforce.