Prominent exostosis projecting from the occipital squama more substantial and prevalent in young adult than older age groups
Two pages on PainSci cite Shahar 2018: 1. Does Posture Matter? 2. As heard on NPR…just barely (Member Post)
PainSci commentary on Shahar 2018: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
This is the junk science that triggered that painfully stupid “cell phone usage causes skull horns” kerfuffle back in 2019. The paper achieved completely undeserved virality and has been accessed many tens of thousands of times. The study (and the media coverage) basically claimed that those darn millenials are staring down at their phones so much that the postural strain on the backs of their heads is causing them to grow "horns" (bones spurs).
Kids these days!
But the study is silly garbage. A correction was published, but it should have been a retraction. The whole incident was a pitch perfect example of the power of fear-mongering misinformation based on so-called science … right before a mighty explosion of much more consequential pandemic examples.
What's so bad about the study? Where to start! Nsikan Apkan’s debunking for PBS.org is ten times more detailed than anything I would have bothered to write about this, despite the fact that it’s exactly the kind of thing I like to write about it — but Akpan really goes for it, leaves no stone unturned, and even gets into tangential detail about the overwhelming power of misinformation. It’s truly great high-road debunking. Bravo!
But Apkan’s piece might be a little too much of a good thing, taking a silly topic a bit too seriously. There’s really just one thing 99% of people need to know about this study: it was self-serving junk science, and the conclusion and the headlines it generated were clickbait crap unworthy of our attention.
But here are a few highlights (or lowlights) extracted from Apkan's detailed work …
- The study has numerous flaws, but the most obvious is that they didn’t measure cell phone usage. So they really cannot say anything about any correlation between cell phone usage and bone spurs.
- The X-ray data is fishy: inconsistent imaging conditions, without enough data about them made available to audit.
- They studied only chiropractic patients — a rather skewed sample.
- The paper says males have more of these bone spurs, but there's no data to back that up.
- Nor is any clear connection to millennials actually made.
- Shahar is a chiropractor who sells posture correction gadgets, so he has a blatant bias and conflict of interest. It’s extremely likely that "P-hacking" is a factor: torturing the data until it tells you what you want hear.
- The original paper was so heavy on the speculation that a correction was published, removing the most intense speculation. Even after that, the paper still gives a very strong impression that the authors believe something their data comes nowhere close to supporting. And that premise doesn't just reach beyond the data, it’s also obviously illogical… because human beings are not remotely new to hunching over their work for hours at a time.
- Finally, this study was not published by "the journal Nature," despite being on their website. This is a Scientific Reports publication, a Nature subsidiary, and a pay-to-publish open access journal (with far lower average quality and credibility than the journal Nature proper). This study is a perfect example of terrible science that someone literally paid to publish, and benefitted hugely from Nature's aura of credibility. Frustrating.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Recently we reported the development of prominent exostosis young adults' skulls (41%; 10-31mm) emanating from the external occipital protuberance (EOP). These findings contrast existing reports that large enthesophytes are not seen in young adults. Here we show that a combination sex, the degree of forward head protraction (FHP) and age predicted the presence of enlarged EOP (EEOP) (n=1200, age 18-86). While being a male and increased FHP had a positive effect on prominent exostosis, paradoxically, increase in age was linked to a decrease in enthesophyte size. Our latter findings provide a conundrum, as the frequency and severity of degenerative skeletal features in humans are associated typically with aging. Our findings and the literature provide evidence that mechanical load plays a vital role in the development and maintenance of the enthesis (insertion) and draws a direct link between aberrant loading of the enthesis and related pathologies. We hypothesize EEOP may be linked to sustained aberrant postures associated with the emergence and extensive use of hand-held contemporary technologies, such as smartphones and tablets. Our findings raise a concern about the future musculoskeletal health of the young adult population and reinforce the need for prevention intervention through posture improvement education.
related content
Specifically regarding Shahar 2018:
- “Science journal walks back claim that smartphones make millennials grow horns,” Nsikan Akpan, www.pbs.org.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
- Placebo analgesia in physical and psychological interventions: Systematic review and meta-analysis of three-armed trials. Hohenschurz-Schmidt 2024 Eur J Pain.
- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.