The World Health Organization has recently highlighted a sharp rise in problematic digital device use among adolescents (1). Alongside well-documented mental health consequences, growing evidence links excessive smartphone and internet use to somatic symptoms, including headache and musculoskeletal pain (2). These associations warrant closer methodological scrutiny to distinguish correlation from causation and inform targeted prevention.Parra-Fernandez et al. address a clinically meaningful and increasingly visible issue: the cooccurrence of adolescent musculoskeletal pain and mobile phone dependence (MPD) (3). In their school-based cross-sectional sample of 622 adolescents (10-18 years), more than half reported pain in at least one body region during the preceding six months, with upper back and neck pain being most prevalent. The authors also report higher MPD scores among adolescents reporting pain and identify the mobile phone "abuse and difficulty regulating use" dimension as significantly associated with general pain and neck pain in logistic regression models. These findings are valuable for pain researchers because they move beyond screen time as a single exposure and instead examine dependence-related dimensions of device use. This commentary has three objectives: (1) to examine whether psychosocial factors may confound or mediate the reported MPD-pain associations; (2) to consider whether disaggregating device dependence by activity type could sharpen exposure assessment; and (3) to discuss how pain phenotyping and temporal alignment of measures could strengthen inference. These suggestions are offered to build on the contribution of the original study and to support comparability in future work.
Sergey Tereshchenko (Wed,) studied this question.