Youth Technology Usage And Musculoskeletal Symptoms

There is no doubt that the world our children are growing up in is vastly different from the world their parents knew as children.  Electronic devices have changed so many aspects of our lives.  They provide convenience and increased accessibility making many tasks quicker and easier.   Even children are utilizing these devices more and more frequently.

A Pew Research Center Survey conducted September – October 2023, revealed that despite negative headlines and concerns regarding impact on youth by social media and gaming, teens continue to use these platforms at very high rates.  A third of teens surveyed reported using YouTube, TikTok, Snapchat, Instagram and/or Facebook “almost constantly.”  More than 90% of teens say they use the internet at least daily with almost half saying they use it “almost constantly.”  While that hasn’t changed much since 2022, it is almost double the rate in 2014-2015 (24%).

Usage of devices increases with age with 50% of those aged 15-17 reporting near-constant use compared to 40% of younger teens.  Smartphones are a significant factor as they have become almost universal.   The Pew survey showed that 95% of teens have or have access to a smartphone.  This is followed closely by desktop or laptop computer (90%), gaming console (83%), and to a lesser degree, but still the majority, tablet (65%).

Unfortunately, the ease of access to devices and the conveniences they provide comes with a cost.  It is now taking a toll on other aspects of life, including musculoskeletal health, visual symptoms, psychosocial health and quality of life – even in children.

Researchers surveyed over 1,000 children and adolescents aged 9-17 regarding their device usage and it’s impact on their health and life.   The electronic devices in question included smartphones, tablets, computers, and game consoles.  They found that 61% of all students spent more than 2 hours per school day using electronic devices.  That number jumps to 78% on weekends and holidays.  While the American Academy of Pediatrics recommends no more than 2 hours of daily screen time, it has been reported that American children spend an average of 6.43 hours on screen-based media.

The longer usage was associated with:

• Increased prevalence and severity of musculoskeletal symptoms (neck/shoulder pain, lower back pain, and arm discomfort)
• Visual symptoms (Computer Vision Syndrome or CVS, which is associated with a set of specific symptoms, including burning sensations, dryness, and tearing in the eyes, blurry vision, eye strain, and slow focusing)
• Poorer device use-related psychosocial health (sleep disruption, parental relationship problems, school performance problems, mental health problems, and daytime fatigue).

The most prevalent symptoms reported during and/or after device usage were:

• 53% reported at least occasional neck pain or aches
• 52% reported neck tiredness
• 55% eye dryness.

Additionally, when reviewing reports for all musculoskeletal and visual symptoms the frequency was significantly higher among older students compared to their younger counterparts.  Specifically, low back pain or ache, eye tearing, and eye dryness, the older students reported these symptoms 5-8 times more than primary school students.  While 67% – 72% of students reported mild musculoskeletal symptoms, 18% – 22% reported moderate symptoms and 1% – 3% reported severe symptoms.  This was similar to the visual symptoms with 65% – 77% reporting mild, 11% – 21% reporting moderate and 1% – 5% reporting severe symptoms.  As with the frequency, older students reported higher rate of increased intensity compared to the younger students.

The most common musculoskeletal symptoms reported were neck pain or aches (53%) and neck tiredness (52%).  Maintaining a position with constant muscle contraction and/or flexed neck posture, not enough posture breaks and poor ergonomic workstation set-up are all possible factors influencing these symptoms.  There was also a dose-dependent association with each hour of daily smartphone usage incurs a 4% – 7% increase in the odds of experiencing musculoskeletal symptoms.

The issues associated with electronic device usage were not limited to physical health.  Most of the students reported issues with 3 of the 6 components that were surveyed:

• 72% using electronic devices longer than intended
• 68% others complained about the time the student spent on their device
• 55% experienced sleep disruption due to late night usage.

Once again, older students tended to report these issues more frequently (1.2 up to 8.9 times more).  Researchers noted significant relationships between time spent on devices and reduced physical activity and sleep duration, and poorer family relationship and academic performance.

The higher rates of symptoms and issues among older students may be related to their increased usage compared to the younger students.   Therefore, the researchers concluded that “early intervention targeted at primary school or even earlier to minimize the development of electronic device habits in youth” is of “critical importance”.  They acknowledge that the high rate of electronic devices utilized in education makes strictly limiting usage impractical for most.  However, recreational usage limitations are “crucial”.  Additionally, they suggest frequent breaks between classes, and adding time for physical education that includes activities targeting musculoskeletal health as possible methods to reduce the physical impact on the student’s bodies.  They also advise that parents can help by utilizing more structure for the child’s device usage as well as by being a good role model and demonstrating healthy limits with screen time themselves.

As experts in the musculoskeletal system, chiropractors can provide excellent advice and recommendations regarding ergonomic and posture needs as well as stretches, exercises or other activities to help combat the physical toll modern conveniences can take on the body.  Additionally, during regular check-ups, a doctor of chiropractic can recognize and correct minor issues with posture before they become big problems.  For children and adolescents who are still growing, they can help ensure that misalignments are identified and corrected early, to help enable the child to develop to their fullest potential.

 

RESOURCES:

Tsang SMH, Cheing GLY, Lam AKC, Siu AMH, Pang PCK, Yip KC, Chan JWK, Jensen MP. Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study. Front Public Health. 2023 Jun 29;11:1178769. doi: 10.3389/fpubh.2023.1178769. PMID: 37457285; PMCID: PMC10338872.

Anderson, Monica; Faverio, Michelle; Gottfried, Jeffrey.  “Teens, Social Media and Technology 2023 – YouTube, TikTok, Snapchat and Instagram remain the most widely used online platforms among U.S. teens”  Pew Research Center December 11, 2023  https://www.pewresearch.org/internet/2023/12/11/teens-social-media-and-technology-2023/  Accessed 12/11/23