European Journal of Biomedical and Pharmaceutical Sciences

PREVALENCE OF MECHANICAL NECK PAIN AND ITS ASSOCIATION WITH SMARTPHONE USE, SMARTPHONE ADDICTION, NECK DISABILITY, AND CERVICAL RANGE OF MOTION AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY

*Tehreem Fatima, Ameer Hamza

ABSTRACT

Background: Smartphones have become an essential part of university students' daily lives, supporting academic work, communication, entertainment, and social interaction. Extended smartphone use often encourages prolonged neck flexion and poor postural habits, increasing mechanical stress on the cervical spine and potentially contributing to musculoskeletal discomfort. While some studies have indicated the relationship between smartphone use and neck pain, few studies have simultaneously investigated the issue of smartphone addiction, neck disability, and cervical range of motion in the same group of people. Objective: To identify the prevalence of mechanical neck pain in university students and its relationship with smartphone usage, smartphone addiction, neck disability, and cervical range of motion. Methods: A cross-sectional observational study was conducted to investigate 100 university students who frequently use their smartphones. Data collection instruments included a well-structured questionnaire that contained demographics, Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), Nordic Musculoskeletal Questionnaire (NMQ), and Smartphone Addiction Scale – Short Version (SAS-SV). The cervical range of motion was measured using a universal goniometer. Data analysis involved descriptive statistics. Normality of data was tested using the Shapiro-Wilk test, while the correlation among study variables was determined using Spearman's rank-order correlation. Internal consistency for the NDI and SAS-SV was assessed using Cronbach's alpha. A p-value of <0.05 was considered statistically significant. Results: The average age of participants was 21.43 ± 1.51 years, and the average body mass index was 24.10 ± 4.77 kg/m². Current mechanical neck pain was found among 45% of participants, while 25% reported a past history of neck pain. The average NPRS score was 2.38 ± 2.30, NDI score was 25.56 ± 20.40%, and SAS-SV score was 33.31 ± 12.23. Usage of smartphones showed statistically significant positive associations with pain intensity (rₛ = 0.327, p < 0.001), neck disability (rₛ = 0.323, p = 0.001), and smartphone addiction (rₛ = 0.552, p < 0.001). Pain intensity had a very strong association with neck disability (rₛ = 0.694, p < 0.001) and had a negative correlation with cervical mobility, especially the right rotation (rₛ = –0.444, p < 0.001). The NDI and SAS-SV were found to have excellent internal consistency (Cronbach's α = 0.940 and 0.949, respectively).
Conclusion: Neck pain arising from mechanical factors is common among university students and is strongly related to increased use of smartphones, high smartphone addiction scores, high levels of neck disability, and poor range of motion of the neck. The results imply the need for ergonomically correct use of smartphones and preventive measures against musculoskeletal disorders of the neck.

Keywords: Mechanical neck pain; Smartphone use; Smartphone addiction; Neck disability; Cervical range of motion; University students; Text neck.