Abstract
Background:
The rapid proliferation of smartphone use among young adults has raised concerns about its impact on physical health, particularly musculoskeletal pain. Prolonged screen time and poor ergonomic habits have been linked to discomfort in the neck, shoulders, wrists, and elbows.
Objective:
To assess the association between smartphone addiction and musculoskeletal pain among university students in India.
Methods:
A cross-sectional study was conducted among university students aged 18–26 who used digital devices for a minimum of 3 h daily. Participants were assessed using validated tools, including the Smartphone Addiction Scale—Short Version (SAS-SV), Nordic Musculoskeletal Questionnaire (NMQ), Shoulder Pain and Disability Index (SPADI), Neck Disability Index (NDI), and the Cornell Hand Discomfort Questionnaire (CHDQ). Data were collected via Google Forms and analyzed.
Results:
Out of 321 respondents, those with high SAS-SV scores (>40) showed a significantly higher prevalence of musculoskeletal pain in the neck (85%), wrists/hands (62.5%), and shoulders (50%) compared to low usage groups (P < 0.05). Functional impairments in academic activities were also more frequent in the high usage group, particularly due to neck (27.5%) and wrist/hand pain (20.0%). Females and dental students reported a higher incidence of neck and wrist discomfort.
Conclusion:
Excessive smartphone use is significantly associated with musculoskeletal pain and functional impairment among young adults. These findings underscore the urgent need for ergonomic education, behavioral interventions, and further longitudinal research to mitigate the health risks of prolonged screen exposure in university populations.
Keywords: Digital device usage, ergonomics, musculoskeletal pain, neck pain, screen time, smartphone addiction
INTRODUCTION
The exponential rise in smartphone adoption and increasing engagement with digital platforms among young adults have sparked significant public health inquiries, particularly concerning the associated risks of musculoskeletal pain. Existing literature highlights a strong correlation between prolonged screen exposure and musculoskeletal discomfort, notably in regions such as the neck, shoulders, and upper extremities.[1] A distressingly high prevalence of musculoskeletal symptoms, particularly among young adults immersed in digital technology, points to the urgent need for systematic investigation into these developments[2] and mental well-being. Excessive screen usage has been connected to issues like smartphone addiction, which exacerbates sedentary lifestyles and psychological stress. As smartphones have become integral in daily life, young adults frequently confront both physical discomfort and mental health challenges as a result of their usage patterns.[3]
Aim of the study
To assess the relationship between smartphone addiction and musculoskeletal pain among university students.
METHODS
Study design and participants
A cross-sectional study was conducted over six months among medical science students—including those from Medicine, Dentistry, Allied Health Sciences, and Paramedical courses—at SRM Medical College Hospital and Research Centre, Tamil Nadu, India. The study targeted university students aged 18–26 years who reported using digital devices for a minimum of 3 h per day. The exclusion criteria targeted individuals with pre-existing musculoskeletal conditions to reduce bias in results.
Instruments
The following validated questionnaires were utilized for data collection:
Nordic Musculoskeletal Questionnaire (NMQ): Assesses the presence and severity of musculoskeletal symptoms.
Shoulder Pain and Disability Index (SPADI): Assesses pain and disability specifically in the shoulder region.
Neck Disability Index (NDI): Measures functional impairment attributable to neck pain.
Cornell Hand Discomfort Questionnaire (CHDQ): Assesses levels of discomfort in the hands.
RESULTS
Table 1 highlights a clear trend of increasing musculoskeletal pain prevalence with higher smartphone usage, as measured by the SAS-SV. Students in the high usage group (SAS-SV >40) reported significantly higher 12-month and 7-day pain in the neck, shoulders, and wrists/hands compared to the low usage group (P < 0.05). Neck pain was the most prevalent, affecting 85% over 12 months and 40% over 7 days among high users. These findings suggest a strong association between excessive smartphone use and upper-body musculoskeletal discomfort.
Table 1.
Musculoskeletal Pain Prevalence by Smartphone Usage Level
| Body Part | Low Usage (SAS-SV <20, n=32) | Moderate Usage (SAS-SV 20–40, n=209) | High Usage (SAS-SV >40, n=80) | P |
|---|---|---|---|---|
| Neck | ||||
| 12-Month, n (%) | 12 (37.5) | 145 (69.4) | 68 (85.0)* | <0.01 |
| 7-Day, n (%) | 4 (12.5) | 60 (28.7) | 32 (40.0)* | <0.05 |
| Shoulders | ||||
| 12-Month, n (%) | 8 (25.0) | 80 (38.3) | 40 (50.0)* | <0.05 |
| 7-Day, n (%) | 2 (6.3) | 40 (19.1) | 22 (27.5)* | <0.05 |
| Wrists/Hands | ||||
| 12-Month, n (%) | 10 (31.3) | 100 (47.8) | 50 (62.5)* | <0.01 |
| 7-Day, n (%) | 3 (9.4) | 50 (23.9) | 27 (33.8)* | <0.05 |
| Elbows | ||||
| 12-Month, n (%) | 4 (12.5) | 40 (19.1) | 20 (25.0) | 0.09 |
| 7-Day, n (%) | 1 (3.1) | 20 (9.6) | 11 (13.8) | 0.12 |
Prevalence based on modified NMQ. P values from Chi-square test; *P<0.05 vs. Low Usage. SAS-SV=Smartphone Addiction Scale—Short Version
Table 2 shows that musculoskeletal pain-related disruption to work or study increases with higher smartphone usage. Notably, neck (27.5%) and wrist/hand (20.0%) disruptions were significantly more common in the high usage group (P < 0.05), compared to low usage.
Table 2.
Severity of Musculoskeletal Pain (Work Disruption) by Smartphone Usage Level
| Body Part | Low Usage (SAS-SV <20, n=32) | Moderate Usage (SAS-SV 20–40, n=209) | High Usage (SAS-SV >40, n=80) | P |
|---|---|---|---|---|
| Neck | 2 (6.3%) | 40 (19.1%) | 22 (27.5%)* | <0.05 |
| Shoulders | 1 (3.1%) | 20 (9.6%) | 11 (13.8%) | 0.1 |
| Wrists/Hands | 2 (6.3%) | 30 (14.4%) | 16 (20.0%)* | <0.05 |
| Elbows | 0 (0.0%) | 10 (4.8%) | 6 (7.5%) | 0.15 |
*P<0.05. SAS-SV=Smartphone Addiction Scale—Short Version
Among participants with high smartphone addiction (SAS-SV >40), neck and wrist pain were more prevalent in females and dental students. Females reported significantly higher neck (88.5%) and wrist (65.6%) pain compared to males (73.7% and 52.6%, respectively; P < 0.05). These findings suggest gender and field of study as potential risk factors for musculoskeletal pain in high smartphone users.
Table 3 shows moderate positive correlations between SAS-SV scores and musculoskeletal pain, particularly in the neck and wrist regions (r = 0.5; 95% confidence interval [CI]: 0.40–0.60), with 85% and 62.5% of high smartphone users reporting neck and wrist pain, respectively.
Table 3.
Estimated Correlations Between Smartphone Addiction Scale–Short Version (SAS-SV) Scores and Musculoskeletal Pain Prevalence
| Relationship | Estimated Correlation (r) | 95% Confidence Interval | Key Finding |
|---|---|---|---|
| SAS-SV vs. Neck pain | 0.5 | 0.40–0.60 | 85% of participants with high SAS-SV scores reported neck pain. |
| SAS-SV vs. Wrist pain | 0.5 | 0.40–0.60 | 62.5% of participants with high SAS-SV scores reported wrist pain. |
| SAS-SV vs. Shoulder pain | 0.3 | 0.20–0.40 | 50% of participants with high SAS-SV scores reported shoulder pain. |
| SAS-SV vs. Elbow pain | 0.2 | 0.10 – 0.30 | 25% of participants with high SAS-SV scores reported elbow pain. |
Note: Correlation coefficients (r) are estimated based on co-occurrence data; calculation of actual Pearson correlation coefficients requires access to raw individual-level data. CI=Confidence interval. SAS-SV=Smartphone Addiction Scale—Short Version
DISCUSSION
These findings reinforce the documented connections between prolonged screen usage and the incidence of musculoskeletal disorders among young adults. The reported high rates of neck and shoulder discomfort coincide with global trends indicating that excessive digital engagement often leads to postural complications and associated pain conditions.[4] Systematic reviews suggest that screen time adversely affects not only physical health but also mental well-being, with participants experiencing greater levels of stress and sleep disturbances linked to their screen habits.[5]
Moreover, the identified correlation between smartphone addiction and musculoskeletal pain underscores a critical aspect of modern lifestyle choices among youths, highlighting the need for comprehensive interventions aimed at promoting ergonomic practices and behavioral adjustments to mitigate health risks associated with extensive digital device usage.[6] Regular breaks, ergonomic education, and encouraging physical activity are proposed pathways to enhance health among university students navigating this technology-rich environment.[7]
CONCLUSION
This study indicates a significant correlation between increased screen time and musculoskeletal pain prevalence among young adults. The need for targeted ergonomic interventions and public health strategies to promote healthier technology usage habits is pressing.
Ethical clearance
This study was approved by the Institutional Ethics Committee of SRM Medical College Hospital and Research Centre, Chennai.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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