A One-Week Physiotherapeutic Intervention
By Adeeba Bashir PT and Showkat Maqbool PT
Text neck syndrome, an increasingly prevalent musculoskeletal condition characterized by forward head posture and cervical spine strain attributed to prolonged screen use, can lead to significant discomfort and postural deformity. This case report details the rapid improvement of a 31 year old female IT professional presenting with text neck syndrome, who demonstrated marked radiographic and clinical recovery within one week of targeted physiotherapy intervention. Pre- and post-treatment lateral cervical spine X-rays provide compelling visual evidence of the therapeutic response.
This case highlights the effectiveness of early, targeted physiotherapeutic intervention in reversing functional and structural abnormalities caused by digital posture habits.
Introduction
With the ubiquity of smartphones and prolonged screen engagement, text neck syndrome has emerged as a modern-day postural ailment. Characterized by anterior head carriage, cervical kyphosis, and associated musculoskeletal symptoms, it can lead to chronic discomfort and functional limitations if left unaddressed. While gradual improvement through physiotherapy is well documented, acute radiographic changes within a week remain rare. This report presents a unique case of swift correction, highlighting the potential for rapid postural rehabilitation with appropriate intervention.
Case Presentation
A 31-year-old female IT professional presented to the physiotherapy clinic with complaints of dull, persistent neck pain radiating to the shoulders, accompanied by frequent tension headaches and fatigue. Symptoms had been progressively worsening over six months, coinciding with extended remote work hours and increased mobile phone usage. The patient had no history of trauma, systemic disease, or prior cervical spine pathology.
Clinical Examination:
1) Posture: Forward head posture, rounded shoulders
2) Pain Scale: 8/10 on Visual Analog Scale (VAS)
3) Range of Motion: Mild restriction in cervical flexion and rotation
4) Muscle Palpation: Trigger points noted in upper trapezius and levator scapulae
5) Neurological: No signs of radiculopathy or myelopathy
6) X-Ray Findings (Day 1): Loss of cervical lordosis, indicative of functional straightening with anterior head positioning, consistent with text neck syndrome.
Clinical Findings
Initial examination revealed:
1) Forward head posture
2) Flattened cervical lordosis
3) Palpable tightness in the upper trapezius, levator scapulae, and sub occipital muscles
4) Pain intensity: 8/10 on the Numeric Pain Rating Scale (NPRS)
5) Neck Disability Index (NDI): 22% (moderate disability)
6) Cervical Range of Motion (ROM): restricted flexion (35°), extension (30°), and rotation bilaterally (45°)
Intervention
The patient underwent a structured physiotherapy program for seven consecutive days, with daily 45- minute to 1 hour sessions. The intervention was designed to address muscular imbalances, restore cervical alignment, and reduce symptom severity.
Treatment Components
1) Postural education:
Instructions were provided regarding optimal desk ergonomics, screen positioning, and frequent micro-breaks.
2) Manual Therapy:
- Soft tissue mobilization b. Trigger point release c. Joint mobilizations *MAITLAND APPROACH (Grades I–II) for cervical spine *MULLIGAN APPROACH
NAG (Natural Apophyseal Glides) SNAG (Sustained Natural Apophyseal Glides). *CYRIAX MANIPULATION
3) Therapeutic Exercises: a. Cervical stabilization exercises (chin tucks, deep neck flexor strengthening) b. Scapular retraction drills c. Stretching of pectoral muscles
4) Neuromuscular Re-Education: Mirror feedback and proprioceptive training to encourage head retraction and alignment.
5) Electrotherapy: TENS (Transcutaneous Electrical Nerve Stimulation) for pain modulation
6) Home Exercise Program:
Continuation of postural drills and stretches.
Outcome Measures and Results
After one week, the patient reported significant improvement: a reduction in pain improved range of motion, and enhanced awareness of posture.
The radiological comparison clearly illustrated a transition from a reverse lordotic cervical curve to a near-normal physiological curvature.
Clinical Outcomes (Day 1 vs. Day 7)
Outcome Measure
NPRS NDI Cervical Flexion Cervical Extension
Radiographic Outcomes
Day 1
8/10 22% 35° 30°
Day 7
2/10 8% 50o 45°
BEFORE
AFTER
Follow-up radiographs on Day 7 revealed: Near normal restoration of cervical lordosis Decreased anterior head projection Improved vertebral alignment
Discussion
This case emphasizes the responsiveness of early-stage postural syndromes like text neck to focused rehabilitation. While radiographic improvements are typically slow to manifest, this instance underscores that when postural deviations are functional rather than structural, correction can be rapid. The improvement also aligns with emerging evidence suggesting that cervical alignment may be more dynamic than previously believed, particularly in younger individuals without degenerative changes.
The interdisciplinary approach, combining manual therapy with neuromuscular re-education, likely accelerated the patient's recovery. This case advocates for early identification and intervention in text neck syndrome to prevent chronicity and potential degenerative progression.
However, this case also underscores the importance of early intervention and consistent adherence to exercise, posture & ergonomic practices to prevent recurrence.
Conclusion
This report documents a rare case of radiographically evident postural correction within one week of physiotherapy in a patient with text neck syndrome.
A short-duration, multi-modal physiotherapeutic intervention led to substantial clinical and radiographic improvements. These findings suggest that early-stage TNS may respond favourably to structured, intensive rehabilitation. Further studies with larger sample sizes and long-term follow-up are recommended to validate and expand upon these results.
The authors are physiotherapists practicing at Ujala Cygnus Kashmir.
