No, spending hours on Twitter, scrolling Instagram or sending memes to your friends probably won’t give you horns. (It’s still not that great for your health though.) A 2018 article published in Nature: Scientific Reports resurfaced this week with a worrisome warning: craning our necks to stare at smart devices is causing twin bony protrusions to show up on the back of our heads. However, the study didn’t actually measure cell phone usage at all and used a population of chiropractic patients already experiencing neck pain, with no healthy individuals as a control method.
The study gained recent attention because it was included in a larger BBC story published on June 13 about the ways in which modern life is altering the human skeleton. Australian media and The Washington Post highlighted the article, running foreboding headlines like: “Horns are growing on young people’s skulls. Phone use is to blame, research suggests.” A bold claim like that stopped other researchers in their tracks, and many took to social media to debunk the findings.
The 2018 paper discussed an alarming prevalence of an enlarged external occipital protuberance (EOP), a bony projection off the back of the skull just above the neck, in young people. It also noted a higher frequency of enlarged EOPs in men. Authors of the study David Shahar and Mark Sayers, both biomechanics experts at the University of Sunshine Coast in Australia, claimed that “…the use of modern technologies and hand-held devices may be primarily responsible for these postures and subsequent development of adaptive robust cranial features in our sample.”
How bad is it? The text says "Sex was the primary predictor with males being 5.48 times more likely to have EEOP than females (P < 0.001)." The figure shows almost no difference between males and females (and young females HIGHER than males). One of these is obviously wrong! pic.twitter.com/CmcGhhejQI— John Hawks (@johnhawks) June 20, 2019
As Kristina Killgrove reports today in Forbes, there are a number of glaring issues in Shahar and Sayers’ study. For one, Shahar claims that he had only been seeing these types of growths in patients over the past decade, and the BBC report states, “Until recently, this type of growth was thought to be extremely rare.” But others—particularly anthropologists and archaeologists—are saying not so.
John Hawks, a paleoanthropologist at the University of Wisconsin, adds on Twitter, “The external occipital protuberance is a well-studied trait in anthropology, and we know a lot about its frequency in different populations. This paper cites none of that.”
Killgrove, who is also an archaeologist at the University of North Carolina Chapel Hill, notes that their finding that the bumps are more common in men has been well known “for centuries” and that these protrusions are often used to identify male skeletons. Nivien Speith, a bioarchaeologist from the University of Derby, explains that there are many ways for one to obtain these skeletal markers.
“I’ve seen plenty of enlarged EOPS in the early Medieval skills I’ve studied,” she told Killgrove. “It could be genetic, or even just a simple bony outgrowth that has unknown etiology. Often, they can occur through trauma to the area as well.”
Experts also flagged issues with the sample population that was used in the 2018 study. All of the individuals in the study—1,200 in total aged 18 to 86—were patients at the same chiropractic clinic. Presumably, writes Killgrove, that means the sample consists of people who were already suffering from neck pain and seeking treatment. To make a clear correlation between enlarged EOPs and phone-induced neck pain, Shahar and Sayers would need to have included people who had no pain to begin with as well.
Their whole premise is based on a logistics model that connects horns with:— Nsikan Akpan (@MoNscience) June 20, 2019
- forward head protraction
But the FHP is high in older adults (as one might expect; Fig.3) as well as the prevalence of horns (fig. 4). pic.twitter.com/0GlCyOUNPC
The authors didn’t actually measure the cell phone usage of their subjects at all, making their claim entirely speculative, as Nsikan Akpan, a science editor at PBS Newshour who also has a PhD in pathobiology, tells Killgrove.
“Without knowing the cell phone use of any of the people whose head x-rays were analyzed, it is impossible to draw conclusions about correlation between cell phone use and skull morphology,” Michael Nitabach, professor of physiology, genetics, and neuroscience at Yale University, tells The Washington Post.
Other experts question the concept of phone-induced bone growth entirely, explaining that poor posture is more likely to cause things like muscle stress. “You’re more likely to get degenerative disc disease or misalignment in your neck than a bone spur growing out of your skull,” David J. Langer, a neurosurgeon at Lenox Hill Hospital in New York, said to the New York Times. “…I hate being a naysayer off the bat, but it seems a little far-fetched.”
Perhaps the biggest point of contention is what the paper’s data actually shows. Hawks posted the primary results figure from the study on Twitter, which displays almost no difference between enlarged EOPs between genders, despite the fact that the paper claims, “sex was the primary predictor with males being 5.48 times more likely to have [enlarged EOP] than females.” In fact, Hawk points out that the plot suggests young females aged 18-29 having a higher rate of EOP enlargement, which contradicts what’s written in the paper’s conclusion.
So how did this story go viral, despite all of the study’s questionable errors? “I’m seeing people forwarding this link who are justifying their own belief that parents should limit their screen time for kids,” Hawks tells Killgrove. And as he writes on Medium, his disbelief isn’t necessarily in the idea behind the paper’s conclusion, but in the methods and data that were used to make it.
“Maybe this trait really is changing…It would be really cool if it’s true,” he writes. “But these studies don’t show that.”
So, while it could still be possible that cell phone use is changing our bodies, to believe it without solid evidence is just being bone-headed.