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WSJ’s look at apps and wearables for ‘text neck’ takes a measured approach


4 Star

A Cure for Digital Addicts’ ‘Text Neck’?

Our Review Summary

African American man reading a text message on smart phone.The story describes two products — a smartphone app and a wearable device — designed to improve posture and, theoretically, reduce neck pain, headaches and other ailments.

The story is very up front about one thing: There is no evidence that either device actually works. However, the story spends a fair amount of time explaining why they may theoretically work. On the one hand, this raises the question of why one would write a story about products when there is no evidence they work. On the other hand, there may be real value in letting readers know how much (or how little) evidence there is to back up the claims of these products.


Why This Matters

Neck pain is a fairly common occurrence. According to The Economic Costs of Pain in the United States, published by the Institute of Medicine, “Data from the 2009 National Health Interview Survey indicate that during a 3-month period…15 percent [of adults] reported having pain in the neck area.” And a large Swedish cohort study, published by BMC Musculoskeletal Disorders in 2012, found that “The one-year prevalence of bothersome neck pain for at least seven consecutive days was 25% (95% confidence interval: 24–25) among women and 16% (95% CI: 15–16) among men.” Neck pain is not necessarily a debilitating health problem, but it does adversely affect quality of life for many people. Ergo, it’s not unreasonable to assume that readers would be interested in technology that purports to offer a simple solution to a vexing ailment. Unfortunately, as this story notes, “neither product has been tested in a human study.”


Does the story adequately discuss the costs of the intervention?


This is a toss-up, since the story tells readers that the wearable device (named Alex) costs $99, but doesn’t tell readers how much the app (named the Text Neck Indicator) costs. A look online tells us the app costs $2.99. For what is essentially a product review, it was an unusual oversight not to include the cost of the app. However, in the event of a toss-up, we try to give the story the benefit of the doubt, so this gets a Satisfactory rating.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


The story states very clearly that there are no proven benefits associated with either product, noting that “neither product has been tested in a human study.” Bonus points for noting that some scientists “caution that neck pain and headaches have complex causes, and—to the surprise of some researchers—a recent study found that better posture doesn’t necessarily prevent pain.”

Does the story adequately explain/quantify the harms of the intervention?

Not Applicable

It’s not clear that either product poses any particular harms. We’ll rate this Not Applicable. However, it’s worth mentioning that just like no one is sure if these devices help, we also don’t know if they hurt. For example, using these products may give false reassurance and lead individuals to stay glued to their devices even longer than they currently are — perhaps exacerbating an existing problem.

Does the story seem to grasp the quality of the evidence?


As noted above, the story clearly states that neither product has been tested in a human study. But the story does briefly discuss two pieces of research related to the theory behind both Alex and the Text Neck Indicator app. One was a single-author study published in 2014 that used a model to calculate stresses in the neck based on posture. That study reported that the force exerted on the cervical spine increased when one tilted one’s head forward. The story then quoted the 2014 study’s author as saying that this extra force could lead to chronic neck pain. It would have been good to get input from an independent source on the relevance of that study’s findings.

The second study, published May 12 in Physical Therapy, found (as the story notes) that there was no link between posture and pain or headaches. Again, it would have been good to get feedback from an independent source on that study. The fact that the story addressed research behind the theory of these products is overall a good thing, and coupled with the candor with which the story addresses the lack of research on these products, it gets a Satisfactory rating.

Does the story commit disease-mongering?

Not Satisfactory

Though the story hedges a bit with its language, it still essentially acknowledges the existence of a condition termed “text neck,” with symptoms including neck pain and headaches, that is caused by poor posture. However, as careful readers will figure out, other parts of the story make such a diagnosis highly problematic. As one expert (a co-author on the Physical Therapy paper) states: “Can you say to the whole population: If you improve your posture you reduce your risk of neck pain? We haven’t the evidence to say that.” And “text neck” itself is a term that has been copyrighted by the inventor of the Text Neck Indicator app. The term is not new to this story, but there’s no evidence that such a thing exists. Even with some of the qualifying language (e.g., “some scientists say…”), the story goes a little too far in discussing a condition that hasn’t been proven.

Does the story use independent sources and identify conflicts of interest?


The story clearly notes relevant conflicts of interest and is very well-sourced for a story of this length, quoting authors of both studies as well as two independent sources. If those independent sources had been asked about the studies, and not just the products, the story would have been stronger.

Does the story compare the new approach with existing alternatives?


The story does cite a physical therapy expert about steps that can be taken to prevent or minimize neck pain. For example, the story says, “When you’re working on a computer or using a device, try to take a break every 15 or 20 minutes and stretch or change position.” That’s good, but for many people experiencing neck pain, it may not be enough. There are a wide array of treatment options for neck pain, depending on the diagnosis of what is causing the pain, including medication (such as NSAIDs like ibuprofen) and physical therapy.

Does the story establish the availability of the treatment/test/product/procedure?


The story tells readers exactly where they can buy an Alex device, and notes that the Text Neck Indicator is an Android app that is already on the market.

Does the story establish the true novelty of the approach?

Not Satisfactory

There are a lot of devices out there that are designed to assess posture in general and, to varying degrees, neck posture. How is Alex different? The story doesn’t make that clear. Similarly, there are a lot of apps out there that are focused on neck posture, such as HeadUp, Forward Head Posture, and Watch Your Neck. How do they differ from the Text Neck Indicator? The story doesn’t tell us.

Does the story appear to rely solely or largely on a news release?


The story does not appear to rely on a news release.

Total Score: 7 of 9 Satisfactory

Comments (1)

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Youngjoon Chee

May 28, 2016 at 7:26 am

I am a member of Alex team, The human study to validate the effect has not been finished as described. But for the point of ‘novelty of the approach’, Alex is the first and only wearable sensor that can measure the neck posture in daily life. All the other products in the link, is mainly to measure the posture of lower back and pelvic area. So for the text neck, Alex is the first trial.