News Release

Adolescents who use smartphones for more than three hours a day suffer more from back pain

The finding is from a longitudinal study conducted in Brazil. Analyzing data for high school students aged 13-18, it concluded that the problem affects girls more than boys and is associated with physical inactivity and low academic achievement

Peer-Reviewed Publication

Fundação de Amparo à Pesquisa do Estado de São Paulo

Thanks to the popularization of smartphones and tablets, and the multiplication of video channels, computer games and educational apps, children and adolescents are spending more and more time looking at screens, usually with bad posture, which can cause back pain, among other problems.

A study by Brazilian researchers, funded by FAPESP and reported in an article published in the scientific journal Healthcare, identified several risk factors for spinal health, such as looking at screens for more than three hours a day, proximity of the eyes to the screen, and sitting or lying on the stomach.

The study focused on thoracic spine pain (TSP). The thoracic spine is located at the back of the chest (the thorax), mostly between the shoulder blades, extending from the bottom of the neck to the start of the lumbar spine. The data analyzed came from surveys of 14- to 18-year-old male and female students in the first and second years of high school in Bauru, a medium-sized city in São Paulo state.

A baseline questionnaire was completed in March-June 2017 by 1,628 participants, of whom 1,393 completed a follow-up questionnaire in 2018. The analysis showed a one-year prevalence of 38.4% (the proportion reporting TSP in both the baseline and follow-up surveys) and a one-year incidence of 10.1% (new TSP reported only in the follow-up survey). More girls than boys reported TSP.

Risk factors

TSP is common in different age groups of the general population worldwide, with prevalence ranging from 15%-35% in adults and 13%-35% in children and adolescents. Explosive growth in the use of electronic devices during the COVID-19 pandemic clearly made the problem worse. The risk factors associated with TSP are physical, physiological, psychological and behavioral, according to several investigations. There is also strong evidence of the effects of physical activity, sedentary habits and mental disorders on spinal health. All these factors are considered critical by the World Health Organization (WHO) in its latest global review of evidence and guidelines.

“The study can be used to inform health education programs for school students, teachers, staff and parents,” said Alberto de Vitta, first author of the article. He has a PhD in education from the State University of Campinas (UNICAMP) and completed a postdoctoral fellowship in public health at São Paulo State University (UNESP) in Botucatu. 

“This is in line with some of the objectives of the National Curriculum Parameters [PCN, Brazilian government guidelines for secondary schools], according to which schools are responsible for health education, including identification of risks to individual and collective health and interventions to combat them, as well as promotion of self-care habits with regard to the body’s possibilities and limits,” said Vitta, who is currently teaching and researching at Eduvale College as a faculty member in its Department of Physical Therapy in Avaré, São Paulo state, and the University of Sapucaí Valley’s Graduate Program in Education, Knowledge and Society in Pouso Alegre, Minas Gerais state.

Information on risk factors for TSP in high school students is important because children and adolescents with back pain are more inactive, achieve less academically and have more psychosocial problems, according to the article. In addition, fewer studies have been conducted on TSP than on lower back and neck pain. A systematic review of the literature on TSP found only two prospective studies regarding prognostic factors.

The other authors of the article are Matias Noll of the Federal Institute of Goiás (IFG) and the Federal University of Goiás’s School of Physical Education and Dance (FEFD-UFG) in Brazil; Nicoly Machado Maciel of the University of São Paulo (USP); and Manuel Monfort-Pañego and Vicente Miñana-Signes of the University of Valencia in Spain.

About São Paulo Research Foundation (FAPESP)

The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at and visit FAPESP news agency at to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at

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