Neck pain associated with smartphone usage among university students
Authors: Maayah Mikhled Falah , Nawasreh Zakariya H. , Gaowgzeh Riziq Allah M. , Neamatallah Ziyad , Alfawaz Saad S. , Alabasi Umar M. 
Published: June 2023

Objective
Neck and shoulder pain has been linked to prolonged periods of flexed neck posture. However, the influences of factors related to individuals’ characteristics and the time duration and position of using smartphones on the severity and duration of neck and shoulder pain among university students are not well studied. The aim of this study was to identify factors related to individual demographics, the history of neck pain, and the time duration and positions of using the smartphone that could be associated with neck pain severity and duration and to determine the influence of these factors on neck pain severity and duration among university students.

Subjects and methods
A cross-sectional study was conducted on students from King Abdulaziz University in Jeddah, Saudi Arabia, using a self-administered online questionnaire. Data was collected between March 10th, 2020, and October 18th, 2020, with 867 questionnaires filled out using Google Forms as a web-based questionnaire. Questionnaires were distributed to students by posting them in their batch groups on Facebook, an online social media and social networking service. Students from five healthcare faculties were included: the faculties of medicine, dentistry, pharmacy, nursing, and medical rehabilitation sciences.

Results
Students’ gender, time spent on using their phones, time spent on devices for studying, and having a history of neck or shoulder pain were significant predictors of neck pain duration in the univariate model (p≤0.018). In the multivariate model, both having a history of neck or shoulder pain (95%CI: -2.357 to -1.268, p<0.001) and the hand-side used for writing (95%CI: 0.254–0.512, p<0.001) were significant predictors of neck pain severity, and they both explained 8.4% of its variance. A previous history of neck and shoulder pain, as well as time spent studying on devices, were predictors of the duration of neck pain. According to a study by researchers at Cardiff University, the hand side used for writing on smart devices was also a good predictor of the severity of neck pain. A history of neck or shoulder pain (95% CI: 0.567–0.738, p = <0.001) and the number of hours spent on the device for studying (95% CI: 0.254–0.512, p<0.001) were significant predictors of neck and shoulder pain duration, and they both explained 8.4% of its variance. While having a history of neck or shoulder pain (95% CI: 0.639–0.748, p<0.001) and the hand-side used for writing (95% CI: -1.18 - -0.081, p = 0.025) were significant predictors of neck and shoulder pain severity, they explained 11.3% of its variance.

Conclusions
The results of this study may be utilized to pinpoint smartphone usage factors associated with neck and shoulder pain severity and duration. Further, the findings of this study might help to develop preventive strategies to lower the impacts of these factors on the development of neck and shoulder pain severity and duration among university students.