From the classroom to the office, the everyday habit of looking down at screens is making Malaysians suffer from text neck syndrome, a preventable condition causing long-term neck and shoulder pain, and threatening neurological function.
Dr Chang Kok Chun, Consultant Orthopaedic, Trauma and Spine Surgeon at Sunway Medical Centre Velocity (SMCV)
With an average screen time of 8 hours and 17 minutes daily, Malaysians now rank among the highest digital device users in Asia1. According to Dr Chang Kok Chun, Consultant Orthopaedic, Trauma and Spine Surgeon at Sunway Medical Centre Velocity (SMCV), this will result in ‘text neck syndrome,’ a relatively new condition that has emerged, especially post-pandemic, with a noticeable rise in cases among teenagers and young adults.
This growing health issue is a repetitive stress injury caused by prolonged forward head posture while looking down at screens. “When someone develops text neck, the muscles and joints in the neck undergo continuous strain due to poor posture,” explains Dr Chang. “Over time, this causes muscle and joint fatigue, discomfort, and if left untreated, may even result in structural damage.”
Why Malaysians Are at High Risk?
Malaysia’s high digital consumption, particularly among the younger population, is a significant contributor to the rise of text neck syndrome. The country records the third-highest TikTok usage in Southeast Asia, with an average watch of 121 videos a day1. Combined with long hours at desks or in the classroom, and the lack of ergonomic awareness, this creates the perfect situation for postural strain.
Misalignment occurs when one tilts the head forward by 45 degrees, which increases the load on the cervical spine from only 5 to 22 kilograms2
Thomas Chua Wei Yeh, SMCV’s Physiotherapist and Manager of Rehabilitation Medicine Services
“One of the most common postural issues we see is Forward Head Posture,” says SMCV’s Physiotherapist and Manager of Rehabilitation Medicine Services, Thomas Chua Wei Yeh. Misalignment occurs when one tilts the head forward by 45 degrees, which increases the load on the cervical spine from only 5 to 22 kilograms2. This adds over 1,000 hours of strain on an average user’s spine in just a year, which can lead to symptoms such as neck and shoulder pain, headaches, dizziness, spinal nerve irritation resulting in a tingling sensation of the hands and even early degenerative arthritis3 of the neck.
“Younger patients are more at risk, mainly due to their frequent and prolonged use of smartphones, tablets, and laptops,” Dr Chang notes. He adds, “Text neck is now both an occupational hazard for office workers and a lifestyle-related issue for those who are constantly glued to their devices.” Poor workplace ergonomics further compounds the issue, as many endure long hours at non-conducive desk setups.
This prolonged strain is increasingly linked to higher rates of sick leave in corporate environments, reduced productivity, and declining workplace performance4. The Ministry of Health reports that 67% of Malaysians experience neck pain at some point in their lives5, making it the second most common musculoskeletal complaint in the country6, yet many dismiss the discomfort as temporary or stress-related.
Early Warning Signs to Watch
The early signs of text neck syndrome are often overlooked or misattributed to stress or poor sleep. Symptoms may include persistent neck or upper back stiffness, headaches that begin at the base of the skull, tingling or numbness in the hands and fingers, dizziness or poor balance, difficulty concentrating, eye strain and general fatigue.
“Neck pain is one of the most commonly recognised symptoms, but referred pain to the shoulders and upper back is often missed,” says Dr Chang. He urges Malaysians to pay closer attention to the pain they are feeling and avoid ignoring it to prevent other health complications that could arise from text neck syndrome.
The Hidden Domino Effects of Text Neck Syndrome
If left unmanaged, text neck syndrome can lead to a series of musculoskeletal and neurological complications, including herniated discs, frozen shoulder, or reduced lung capacity from prolonged hunching7. In more advanced cases, compressed cervical nerves may disrupt neural blood flow and nerve signals. Other symptoms that might occur include blurry vision, brain fog, dizziness and difficulty concentrating8.
“The pain will initially provoke protective muscle spasm, which would show in X-ray as straightening of the spine,” Dr Chang explains. “If ignored, this can lead to premature degeneration of the spine, including thinning of the disc between two segments of vertebrae, and the development of bone spurs and facet joint arthritis over time, which is also known as cervical spondylosis (wear and tear of the joint and discs in the neck).
He further warns that this irreversible condition may cause nerve or spinal cord compression, leading to radiating pain, numbness or pins and needles sensation in the arms, forearms and hands. In severe cases, it can cause weakness and paralysis in both the upper and lower limbs. Persistent pain not only affects one physically, but it can also take a toll on mental health and overall well-being. As discomfort lingers, it can interfere with daily routines and diminish quality of life. Over time, individuals may experience reduced productivity, increased irritability or helplessness, especially when relief feels out of reach.
A Path Towards Recovery and Prevention
Managing text neck syndrome typically involves a combination of physiotherapy, lifestyle changes and, in some cases, medication. Dr Chang stresses that the best investment lies in consistent ergonomic practices through reducing screen time, using proper posture and incorporating regular neck relaxation exercises throughout the day.
Thomas adds that physiotherapy plays a critical role in both recovery and prevention. “We use manual therapy, postural retraining and targeted exercises to relieve tension, build strength, and restore proper alignment,” he explains. While most patients begin to notice improvement within three to six sessions, those with more severe conditions may require a longer treatment plan to achieve lasting results.
Treatment plans are tailored to each individual’s lifestyle and physical demands. “For students, we focus on limiting continuous screen time, encouraging posture-friendly reading habits, and optimising backpack use to avoid unnecessary strain on the neck and upper back,” says Thomas. Meanwhile, prioritising ergonomic workstations and integrating mobility breaks, such as stretching routines, is recommended for office workers to reduce muscular fatigue and joint stress.
Progress is tracked through a combination of clinical assessments and patient-reported outcomes. “We assess range of motion to evaluate cervical and thoracic spine mobility, and test muscle strength in key postural areas,” Thomas explains. “Postural analysis helps us monitor alignment changes over time, while pain scales and functional questionnaires offer insights into daily performance and comfort levels.” He adds that improvements such as reduced reliance on pain medication or greater tolerance for daily tasks are also important indicators of recovery.
He also cautions against movements that worsen symptoms, particularly during recovery, such as abdominal crunches, overhead lifting or prolonged typing with a flexed neck. “Rest helps reduce immediate pain, but movement, postural correction, and strengthening are key to long-term recovery.”
While many are aware of the risks, Dr Chang acknowledges that consistent application remains a significant challenge. “Everyone understands the cause and consequences of text neck syndrome, but bad habits are hard to break, and a heavy workload compels us to neglect proper neck and spine care.” Still, he encourages all to start making positive changes, one step at a time, as lasting habits are built upon.
A Wake-Up Call for Malaysians
Text neck syndrome has evolved from a mild postural issue into a serious and preventable health concern, driven by Malaysia’s increasing reliance on digital devices and poor ergonomic habits. While simple changes in posture and screen time habits can reduce the risk, Dr Chang notes that many struggle to maintain these habits. As a result, prolonged strain often goes unchecked, leading to chronic pain, spinal degeneration, and in some cases, irreversible nerve and spinal cord damage.
By fostering early awareness and encouraging sustainable habits such as proper posture, ergonomic setups and regular intermittent neck relaxation exercise, Malaysians can take meaningful steps to reduce the risks of text neck and preserve their spinal health in the digital age.
For more information or to learn more about Sunway Medical Centre Velocity, visit www.sunmedvelocity.com.my (Facebook: Sunway Medical Velocity).
