Text neck is a repeated stress injury as well as pain, sustained from excessive watching or texting on handheld devices for long periods of time. The dependence on mobile phones is increasing rapidly, and people spend long hours on their phones, which leads to various musculoskeletal problems. Individuals with this syndrome usually present with neck pain, restricted cervical range of motion, reduced muscle strength and endurance, altered cervical joint position error, along with postural alterations like forward head posture and rounded shoulders as well.

According to recent research, 79% of those aged 18 to 44 have their phones with them virtually all of the time, with only two hours of their waking day spent without them.

In the neutral position, an adult’s head weighs 10-12 pounds. With the flexion of the head, the load increases towards the neck, and the weight is calculated to be 27, 40, 49, and 60 pounds at 15°, 30°, 45°, and 60° respectively. People who use a smartphone frequently have a downward gaze to focus lower, and keep their heads in a forward position for lengthy periods, which can cause neck strain, eventually hastening the process of ageing in the cervical spine. The symptom can result from improper workstations, poor ergonomics, inadequate breaks, and prolonged improper postures.

Common symptoms of text neck

Common symptoms of text neck include headaches, stiffness, shoulder pain, and persistent neck pain. In more extreme situations, tingling or numbness in the fingers or arms could be present, suggesting that nerves are being squeezed.

Text neck, if ignored and untreated, can result in serious long-term consequences, such as flattening of the spinal curvature, early onset of arthritis, spinal misalignment, spinal degeneration, disc space compression, disc herniation, nerve or muscle damage, inflammation of cervical ligaments, nerve irritation, and an increase in spine curvature.

A case study

Take this case of a young IT professional. He came in with severe neck pain radiating to the right arm and to the thumb. He had developed neurological weakness in the form of a poor hand grip and an inability to extend the wrist.

An MRI revealed a huge C56 disc pressing on the right side of the C6 nerve root, leading to this catastrophe. He was immediately taken up for endoscopic removal of disc, decompression of the affected nerve root, followed by replacement by an artificial disc with the aim to retain movements at that level and to avoid adjacent disc degeneration. He regained all of his lost power and was pain-free immediately, and was able to rejoin work in a week.

Not all people however, end up with the above scenario, and not all require surgical intervention unless neurological weakness is detected. A personalised approach, along with community awareness are both factors that can play a vital role in the rationalisation of text neck syndrome.

Integrated postural training in such cases can be a beneficial approach for individuals, combining pain management with a focus on increasing the cervical range of motion, strengthening, stretching, and postural correction.

Physical therapy methods that include a patient-centered approach, home exercises, and postural correction are the prime aspects of managing this syndrome at an early stage to avoid later consequences.

Physiotherapy interventions can be done to treat text neck syndrome, some of which include local ultrasounds, manual traction and manual exercises, cervical muscle stretching, and McKenzie exercises. There is an increasing need for a structured treatment protocol in such individuals to avoid long-term complications, which are mostly seen at an early age.

Treatment options

Simple changes in lifestyle can often be part of the initial course of treatment. Pain can be relieved and further damage can be avoided with physical treatment, posture correction, stretching exercises, and screen time reduction. Also helpful are ergonomic workstations, supportive chairs, and regular pauses when using a laptop or phone.

Surgery might be considered in situations where the spine has sustained structural damage, such as slipped discs or significant nerve compression. To relieve pressure on the nerves, the standard treatment is to remove the injured disc part. A minimally invasive procedure can be used to accomplish this, resulting in a quicker recovery and less discomfort. Surgery is only advised in cases when conservative measures have failed and the problem interferes with day-to-day functioning.

Prevention is better than cure

It’s easier to prevent text neck than to treat it. Maintaining an active lifestyle, holding displays at eye level, and encouraging proper posture can all have a big impact. In the digital age, spinal health can be significantly protected by early awareness and conscious practices. Spinal issues don’t have to be permanent, but smartphones are. Maintaining a strong and healthy spine while being connected is possible with minor adjustments and consistent attention to posture.

(Dr. Mohit Muttha is a consultant spine surgeon at Manipal Hospital, Kharadi, Pune. He can be reached at Mohit.muttha@manipalhospitals.com)

Twice a week, Mohamed Attiya’s wheelchair rattles over Gaza’s scarred roads so he can visit the machine that is keeping him alive.

The 54-year-old makes the journey from a temporary shelter west of Gaza City to Shifa Hospital in the city’s north. There, he receives dialysis for the kidney failure he was diagnosed with nearly 15 years ago. But the treatment, limited by the war’s destruction and lack of supplies, is not enough to remove all the waste products from his blood.

“It just brings you back from death,” the father of six said.

Many others like him have not made it. They are some of Gaza’s quieter deaths from the war, with no explosion, no debris. But the toll is striking: Over 400 patients, representing around 40% of all dialysis cases in the territory, have died during the 18-month conflict because of lack of proper treatment, according to Gaza’s Health Ministry.

That includes 11 patients who have died since the beginning of March, when Israel sealed the territory’s 2 million Palestinians off from all imports, including food, medical supplies and fuel.

Israeli officials say the aim is to pressure Hamas to release more hostages after Israel ended their ceasefire.

Coordination of Government Activities in the Territories (COGAT), the Israeli military body in charge of coordinating aid, declined to comment on the current blockade. It has said in the past that all medical aid is approved for entry when the crossings are open, and that around 45,400 tonnes of medical equipment have entered Gaza since the start of the war.

Hardships mount for Gaza patients

Mr. Attiya said he needs at least three dialysis sessions every week, at least four hours each time. Now, his two sessions last two or three hours at most.

Israel’s blockade, and its numerous evacuation orders across much of the territory, have challenged his ability to reach regular care.

He has been displaced at least six times since fleeing his home near the northern town of Beit Hanoun in the first weeks of the war.

He first stayed in Rafah in the south, then the central city of Deir al-Balah. When the latest ceasefire took effect in January, he moved again to another school in western Gaza City.

Until recently, Mr. Attiya walked to the hospital for dialysis. But he says the limited treatment, and soaring prices for the mineral water he should be drinking, have left him in a wheelchair.

His family wheels him through a Gaza that many find difficult to recognise. Much of the territory has been destroyed.

“There is no transportation. Streets are damaged,” Mr. Attiya said. “Life is difficult and expensive.” He said he now has hallucinations because of the high levels of toxins in his blood.

“The occupation does not care about the suffering or the sick,” he said, referring to Israel and its soldiers.

A health system gutted by war

Six of the seven dialysis centres in Gaza have been destroyed during the war, the World Health Organisation (WHO) said earlier this year, citing the territory’s Health Ministry.

The territory had 182 dialysis machines before the war and now has 102. Twenty-seven of them are in northern Gaza, where hundreds of thousands of people rushed home during the two-month ceasefire.

“These equipment shortages are exacerbated by zero stock levels of kidney medications,” the WHO said.

Israel has raided hospitals on several occasions during the war, accusing Hamas of using them for military purposes. Hospital staff deny the allegations and say the raids have gutted the territory’s health care system as it struggles to cope with mass casualties from the war.

The Health Ministry says over 51,000 Palestinians, mostly women and children, have been killed in Israel’s offensive, without saying how many were civilians or combatants.

Hamas-led militants killed some 1,200 people, mostly civilians, and abducted 251 in the October 7, 2023 attack that triggered the war.

Officials say hundreds of patients have died

At Shifa Hospital, the head of the nephrology and dialysis department, Dr. Ghazi al-Yazigi, said at least 417 patients with kidney failure have died in Gaza during the war because of lack of proper treatment. That’s from among the 1,100 patients when the war began.

Like Mr. Attiya, hundreds of dialysis patients across Gaza are now forced to settle for fewer and shorter sessions each week.

“This leads to complications such as increased levels of toxins and fluid accumulation… which could lead to death,” Mr. al-Yazigi said.

Mohamed Kamel of Gaza City is a new dialysis patient at the hospital after being diagnosed with kidney failure during the war and beginning treatment this year.

These days, “I feel no improvement after each session,” he said during one of his weekly visits.

The father of six children said he no longer has access to filtered water to drink, and even basic running water is scarce. Israel last month cut off the electricity supply to Gaza, affecting a desalination plant producing drinking water for part of the arid territory.

Mr. Kamel said he has missed many dialysis sessions. Last year, while sheltering in central Gaza, he missed one because of an Israeli bombing in the area. His condition deteriorated, and the next day he was taken by ambulance to Al-Aqsa Martyrs hospital.

“The displacement has had consequences,” Mr. Kamel said. “I am tired.”

If someone had told me two years ago that I would lose over 50 kilos without setting foot in a gym or giving up real food, I would not have believed it. But here I am—healthier, sharper, and more confident than I have been in years. My transformation, however, did not begin with a fitness influencer or a fad diet. It began in a hospital bed.

Over the past decade, my body has been through an unrelenting series of medical challenges—each one demanding its own kind of resilience. From a heart attack to chronic infections, surgeries, and even a near-fatal road accident, it has been a continuous test of endurance. Physical pain is one thing, but the emotional toll of living in constant recovery mode is something else entirely.

At my heaviest, I weighed 144 kilos—a number that didn’t just show up on the scale, but in every aspect of my life. I had outgrown more than just my clothes; I had outgrown the energy and confidence I once took for granted. Everyday tasks left me breathless. My sleep was broken. And slowly, without realising it, I had started slipping away from the person I once was.

I wasn’t someone who lived an indulgent or careless life. In fact, I had tried to lose weight many times. But each time I gathered the will to begin, my health threw me off track.

It was frustrating not because I was not trying, but because life kept getting in the way. Over time, the cycle took a toll. I began gaining more weight, developed sleep issues, and struggled with constant fatigue. When your health becomes unpredictable, it quietly chips away at your sense of control. You’re not just dealing with pain or procedures—you’re also navigating fear, isolation, vulnerability, and the exhausting cycle of hope and relapse. Add to that the silent effects of sleep apnea and chronic fatigue, and it becomes harder to distinguish where the physical discomfort ends, and the emotional struggle begins.

Everything changed in late June 2023, when I was hospitalised again. This time, a doctor suggested that I use a BiPAP machine to help me sleep better. That small intervention became the turning point. For the first time in years, I slept through the night and woke up refreshed. That single improvement gave me the energy and the courage to take the first step towards the new me. I began walking. I gave up alcohol to cut out empty calories. From that point on, I didn’t look back.

I didn’t follow any crash diet or subscribe to anything extreme. It took me a while to figure out what would work for me, however. I loved my tandoori chicken and yummy paneer butter masala, the naans, and the oh-so-tasty parathas. I had read enough to know that a daily calorie limit was the starting point. In the beginning, I didn’t think much about nutrients—I just focused on staying within the calorie limit.

Over time, I realised that the nutritional quality of my food matters as much as the quantity, if not more. I started making changes and started feeling noticeably better when I shifted to a more mindful, balanced approach with the right foods. Soon, I was paying closer attention to eating enough proteins, the right (moderate) amount of fats, loading up on low-carb vegetables, cutting out unnecessary carbs, and limiting fruits and beverages. And no alcohol at all. I made my own meal plan—something that would satisfy me both physically and mentally, without feeling like punishment. Eventually, I realised that a high-protein, low-carb, high-fat diet suited my body best.

The trick was also keeping my meals simple and consistent. Chicken, eggs, paneer, fish, curd/Greek yoghurt, and green vegetables became my friends, and I made it a point to eat three proper meals a day while ensuring I never skipped breakfast. I realised soon enough that if the monotony works for you, there is no harm in being repetitive. 

While green tea became a morning and evening beverage favourite, breakfast usually included lightly roasted paneer or stir-fried mushroom or chicken sausages, a couple of eggs (boiled or omelette, sometimes with cheese), curd, and an occasional small portion of fruit. For lunch, I stuck to two small chapatis, two low-carb veggies (like cabbage, cauliflower, beans, mushroom, beetroot, etc.), a protein source like chicken or fish, and curd or Greek yoghurt. For dinner, I stick to grilled chicken or fish, sometimes a salad or tikka, and eggs or paneer.

No intense workouts were needed. Walking daily and staying disciplined with my diet made all the difference. I did not hire a trainer, join a gym, or consult a nutritionist this time—and that was a conscious choice. Every time I had joined a gym in the past, the workouts suggested by trainers would quickly burn me out. The pace was too much, especially at my heaviest; and I knew I wouldn’t be able to sustain it. I did a lot of reading and learned something crucial: fat loss is driven far more by diet than exercise—nearly 80% of the work is what you eat, followed by moderate movement and good rest.

The tougher challenge, however, was mental. There were weeks when nothing seemed to change. I constantly reminded myself: I didn’t gain this weight overnight, so how could I expect to lose it overnight? I focused on small, repeatable habits. I tracked my food. I created routines. And gradually, things started shifting.

It all came down to discipline. Fancy plans or short bursts of motivation wouldn’t get me there—only consistency would. I followed what I now call the 3Es: Eat right, Exercise regularly, and Eliminate excuses. My clothes got looser. I had to dig out jeans I hadn’t worn in over a decade. I started recognising myself again, not just in the mirror, but in the way I felt.

Eventually, I began sharing my journey on Instagram. I just wanted to share what was working for me in an honest, relatable way. To my surprise, people started listening. They said my journey gave them hope—and if I could do it, so could they.

So far, I’ve lost 57 kilos and I’m still going. Today, I’m working on a simple, no-nonsense guide to weight loss and offering personalised consultations. Not as a nutritionist or fitness coach, but as someone who’s been through it, who understands the struggles, and who wants to help others feel like themselves again.

The weight loss journey isn’t about chasing a number. It’s about showing up for yourself. It’s about reclaiming your energy, your joy, and your life.

Niraj is on Instagram @fitwithNBJ