Association between Smartphone Use and Neck Pain among College Students: A Cross-Sectional Study

Background: Prolonged smartphone use often involves maintaining the neck in a flexed position for extended periods. Such sustained postures may increase the likelihood of musculoskeletal discomfort. However, previous studies have reported inconsistent findings regarding the association between smartphone use and neck pain. Objective: To assess the relationship between patterns of smartphone use, particularly the amount of time spent using smartphones each day, and the severity of neck pain among college students. Methods: A cross-sectional study was carried out among 272 college students aged 18-28 years from four colleges affiliated with NTR University between April 17 and May 10, 2026. Information was obtained using a structured, pre-tested questionnaire. The intensity of neck pain was measured using a Visual Analog Scale (VAS) and classified as mild (1-3), moderate (4-6), or severe (7-10). Daily smartphone use was classified as low (<4 hours/day) or high (≥4 hours/day). Data were analyzed using SPSS version 26.0. Results: A total of 320 participants were approached; 272 participated, giving a response rate of 85.0%. The mean age was 21.6 ± 1.4 years. Overall, 38.6% of participants reported >4 hours/day of smartphone usage. Mild, moderate, and severe neck pain were reported by 79.8%, 18.4%, and 1.8% of participants, respectively. Moderate-to-severe pain was more common among high users than low users (30.5% vs. 13.8%; p=0.003). After adjustment, low smartphone use was associated with lower odds of moderate-to-severe neck pain (aOR=0.37, 95% CI: 0.18-0.73, p=0.004). Conclusion: Greater daily smartphone exposure was associated with higher neck pain severity among the college students studied.