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Running Head: SMARTPHONES AND HORNS

Smartphones and Horns:

A Viral Study of Skeletal Health

Grace Ewals

Minnesota State University, Mankato

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“An important question is what the future holds for the young adult populations . . .

when development of a degenerative process is evident in such an early stage of their lives?”

(Shahar & Sayers, 2018, para. 12). To young adults and parents this statement can be alarming.

Questions raised by a recent study have elicited a huge public reaction (Akman, 2019a). The

study claims the younger population suffers from unusual bone growth caused by deviant

posture while using smartphones (Shahar & Sayers, 2018). Many believe that proving

smartphones cause bodies to change physically is a huge discovery (Grady, 2019b). Headlines

about phones causing horn growth on millennial’s heads have spurred great controversy in the

news industry because of questions raised about the integrity and scientific strength of the

study. Well-known news platforms have published articles disseminating the study, but others

refute it due to undisclosed biases, logical errors, and the misleading nature of the term

“horns.” 

To start, the media popularized the ideas of David Shahar and Mark G. L. Sayers (Grady,

2019b, para. 4). Shahar and Sayers’ (2018) study describes unusual bone growth on the skull

known as enlarged external occipital protuberance [EEOP] which they believe has become more

common. From their population sample, Shahar and Sayers (2018) claim the growths are found

in 40% of young adults, are more likely in men, and correspond with excessive amounts of

smartphone use. For example, author Zaria Gorvett (2019c) describes a stress injury called

“Text-neck” caused by looking down too much (para. 20). Similarly, she explains that an EEOP

bone spike is a coping mechanism of the body (Gorvett, 2019c). Additionally, Isaac Stanley-

Becker (2019e), explains that the likelihood of having an EEOP decreases with age (para. 40).
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Since publication, articles about the study became viral sensations and received large amounts

of media attention (Akman, 2019a, para. 62). 

Following Shahar and Sayers’ journal publication, an unrevealed conflict of interest led

to the study’s investigation, and articles about the study were updated to reflect this (Stanley-

Becker, 2019e, para. 1). Shahar owns an internet store, has marketed a pillow, and works as a

chiropractor, but he submitted the report with, “no competing interests” (Stanley-Becker,

2019e, para 13). Experts argue that this is a problem because study readers carefully analyze

written work based on the author’s bias (Stanley-Becker, 2019e, para 26). The publisher of the

study has stated that they will, “take action where appropriate,” which may involve updating

the study (Akman, 2019a, para. 10). In turn, Stanley-Becker’s article was updated 8 hours after

its’ initial publication to include more context and an outside expert opinion (Akman, 2019a,

para. 62). Nsikan Akpan (2019) expresses concern that some people read the earlier version of

the article and formed a judgement without all the information (para. 70). Despite the study

writers’ mistake, holding a vested interest does not necessarily make research invalid (Stanley-

Becker, 2019e, para 24). Scientists commonly work in their related field, but the lack of

documentation of financial interest in the study is unusual (Stanley-Becker, 2019e).

Additionally, some experts argue that Shahar and Sayers’ data does not substantiate

their hypothesis due to logical errors (Grady, 2019b, para. 6). For example, the study’s text

explains that men are more likely to have EEOP’s than women, but a figure shows very little

difference between men and women with women exceeding men at a point (Hawks, 2019d,

para. 12). Also, the sample population is a pool of chiropractic patients (Grady, 2019b, para. 6).

According to Regina Nuzzo, a senior advisor of the American Statistical Association, “...the study
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is not a random, representative sample” (Akman, 2019a, para. 26). Because of this, percentage

results cannot be translated to the rest of the general population (Grady, 2019b, para. 6).

Furthermore, the study does not measure how much patients use cell phones, so there is not a

direct correlation proving that phones cause EEOP’s to form (Akman, 2019a, para. 17). Studies

on societal habits are cited, but that does not prove that phone use equals EEOP formation

(Akman, 2019a, para. 21). Akpan (2019) expresses further concern that factors such as sex,

gender, and angle of the neck combine into one data set rather than separate (para. 53).

Combined data sets do not prove that a singular variable is responsible for the bone spurs but

that all three may have some impact (Akman, 2019a, para. 56). According to John Hawks

(2019d), a paleoanthropologist, the extensive anthropological data available on EEOP’s is not

cited, which makes it seem like a new discovery when similar research in other fields is

excessive. Because of flaws in logic, the data of Shahar and Sayers’ study has come into

question.

News article headlines describing EEOPs as “horns” are controversial for experts. Titles

such as the Washington Post’s, “‘Horns’ are growing on young people’s skulls. Phone use is to

blame, research suggests” (Stanley-Becker, 2019e), are described as misleading (Hawks, 2019d).

Hawks (2019d) clarifies that horns are a completely different structure than bone because they

are made up of keratin, so the idea of a bone horn is not accurate (para. 3). Similarly, a

neurosurgery chairman was taken aback by the idea of horns because he takes x-rays of skulls

often and has not seen a bone spur (Grady, 2019b, para. 17). In response to headlines and

expert backlash, Shahar illustrated that calling bone formations “horns” is a fitting piece of

imagery meant as an analogy and not a chemical reference (Stanley-Becker, 2019e). In the 2018
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study the term “horns” is not present, so it is likely journalists coined the controversial name

(Hawks, 2019d).

Overall, “growing horns” headlines gather a huge public audience, but there is more

information than meets the eye (Akman, 2019a). Shahar and Sayers (2018) are concerned

about the young adult population because of their handheld device use, but experts argue that

their leap in logic requires further study since the cause of EEOPs is blurry (para.12; Hawks,

2019d). So, young adults might not have cause to panic. Horn formation headlines might seem

frightening, but a deeper understanding of their source reduces confusion. Before throwing

smartphones away, consider working to improve posture in everyday life.

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References

Akpan, N. (2019a, June 25). No, smartphones aren't making millennials grow horns. Here's how

to spot a bad study. KQED. Retrieved from https://www.kqed.org/science/1943902/no-

smartphones-arent-making-millennials-grow-horns-heres-how-to-spot-a-bad-study

Grady, D. (2019b, June 20). About the idea that you're growing horns from looking down at

your phone... Retrieved from https://www.nytimes.com/2019/06/20/health/horns-

cellphones-bones.html

Gorvett, Z. (2019c, June 13). Future - How modern life is transforming the human skeleton.

BBC. Retrieved from http://www.bbc.com/future/story/20190610-how-modern-life-is-

transforming-the-human-skeleton

Hawks, J. (2019d, June 24). Are millennials really growing horns from using their phones?

Medium. Retrieved from https://elemental.medium.com/are-millennials-really-

growing-horns-from-using-their-phones-2b7bd6162938

Shahar, D., & Sayers, M. G. (2018). Prominent exostosis projecting from the occipital squama

more substantial and prevalent in young adult than older age groups. Scientific Reports,

8(1). doi:10.1038/s41598-018-21625-1

Stanley-Becker, I. (2019e, June 25). 'Horns' are growing on young people's skulls. Phone use is

to blame, research suggests. The Washington Post Retrieved from

https://www.washingtonpost.com/nation/2019/06/20/horns-are-growing-young-

peoples-skulls-phone-use-is-blame-research-suggests/?utm_term=.7d22fc66e172