Turtleneck Syndrome

Turtleneck Syndrome, commonly referred to as "text neck," is a modern health concern caused by the excessive forward head posture that occurs when looking down at smartphones, tablets, laptops, or other devices for extended periods. This posture places significant stress on the neck, shoulders, and upper back, leading to discomfort and long-term postural imbalances.

The main symptoms of turtleneck syndrome are as follows:

• Neck pain and stiffness
• Upper back and shoulder discomfort
• Frequent headaches
• Reduced range of motion in the neck
• Tingling or numbness in arms due to nerve compression
• Forward head posture and rounded shoulders

The causes of turtleneck syndrome include, but are not limited to, the following:

1. Prolonged Device Use: Spending hours daily on mobile devices or laptops without breaks strains the cervical spine.
2. Poor Posture: Slouching or leaning forward while sitting or standing contributes to misalignment.
3. Weak Muscles: Lack of core and neck muscle strength can worsen posture and increase strain.
4. Repetitive Strain: Continuous tilting of the head at a downward angle increases the load on neck muscles, which must support up to five times the head's weight in this position.

While it is easy to ignore this issue as a minor inconvenience at first, gradually it can develop into more serious issues such as chronic neck and shoulder pain. The persistent uneven pressure created by a turtleneck posture can also increase the risk of cervical disc herniation. Acupuncture under the IMEAST (Intramuscular Electroacupuncture Stimulation Treatment) protocol helps relieve pain and tension in the neck, shoulders, and upper back by improving blood flow, reducing inflammation, and promoting muscle relaxation. Along with stretching and ergonomic advice, this relief can help the patient retain correct posture, thereby relieving the syndrome.

Treatment Case: 32 years old female

   The patient sought help complaining of chronic neck pain, stiffness, and occasional headaches, especially after prolonged work hours. She reported these symptoms as well as limited neck mobility starting roughly 2 months ago and unfortunately, she has been recently feeling upper back discomfort as well.
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   The patient had long hours of desk work with poor posture (forward head, rounded shoulders), as well as mild stress from work deadlines as an accountant. There were no significant trauma or surgeries related to the cervical spine, and no underlying health issues, except mild hypertension, well-controlled with medication.
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   The clinician noted forward head posture with rounded shoulders (classic turtleneck syndrome) as well as tenderness in the cervical paraspinal muscles and upper trapezius. There was indeed reduced cervical range of motion (especially in flexion and rotation) and hypertonicity in the SCM (sternocleidomastoid) and levator scapulae muscles.
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   Electroacupuncture was prescribed for her twice weekly for 4 weeks, followed by reassessment. Stimulation lasted 20-30 minutes per session, and mostly focused on the muscles of the neck, as well as a little bit on the shoulder area.
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Week 1-2: Reduced neck stiffness and headaches. Improved sleep.
Week 3-4: Noticeable improvement in posture, enhanced range of motion, and less reliance on pain medication.
Follow-up: Incorporate Pilates-based strengthening to sustain results.