Association of Text Neck Syndrome with Upper Trapezius Trigger Points Among Adults: A Cross-Sectional Survey

Abstract

Background: The widespread use of smartphones has resulted in increased cases of Text Neck Syndrome (TNS), a musculoskeletal disorder associated with sustained forward head posture and cervical strain. The upper trapezius muscle is particularly vulnerable to overuse, potentially developing myofascial trigger points (MTrPs) that contribute to neck pain and disability. However, limited data exist on the coexistence of TNS and trapezius trigger points among adults in developing regions. Objective: To determine the prevalence of upper trapezius trigger points in adults with Text Neck Syndrome and to evaluate the association between these two conditions in relation to smartphone usage duration and postural deviation. Methods: A cross-sectional study was conducted among 193 adults aged 17–26 years from educational institutions in Faisalabad, Pakistan. Participants completed questionnaires assessing smartphone use, pain (Numeric Pain Rating Scale, NPRS), and neck disability (Neck Disability Index, NDI). Forward head posture (FHP) was quantified via craniovertebral angle, and MTrPs were identified using standardized palpation criteria. Statistical analysis using SPSS v24 included descriptive statistics, chi-square testing, and Pearson correlation, with significance set at p < 0.05. Results: The mean age was 21.34 ± 2.15 years, and average smartphone use was 7.28 ± 2.11 hours/day. Text Neck Syndrome was diagnosed in 82.4% of participants, and upper trapezius trigger points were found in 64.2%. A significant association existed between TNS and trigger points (χ² = 74.17, p < 0.001; φ = 0.62, 95% CI 0.49–0.73). Forward head posture correlated with both pain intensity (r = 0.44, p < 0.001) and disability (r = 0.48, p < 0.001). Conclusion: Text Neck Syndrome is highly prevalent among young adults and strongly associated with upper trapezius trigger points. Prolonged smartphone use and poor posture significantly contribute to cervical pain and dysfunction, underscoring the need for ergonomic education and preventive physiotherapy interventions