BlackBerry thumb

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BlackBerry thumb

Overuse of the thumb to operate a mobile device may lead to BlackBerry thumb

BlackBerry thumb is a neologism that refers to a form of repetitive strain injury (RSI) caused by the frequent use of the thumbs to press buttons on PDAs, smartphones, or other mobile devices. The name of the condition comes from the BlackBerry, a brand of smartphone that debuted in 1999,[1] although there are numerous other similar eponymous conditions that exist such as "Wiiitis",[2] "Nintendinitis",[3] "Playstation thumb", "cellphone thumb",[4] "smartphone thumb", "Android thumb", and "iPhone thumb". The medical name for the condition is De Quervain syndrome and is associated with the tendons connected to the thumb through the wrist. Causes for the condition extend beyond smartphones and gaming consoles to include activities like golf, racket sports, and lifting.[5]

Symptoms of BlackBerry thumb include aching and throbbing pain in the thumb and wrist.[6] In severe cases, it can lead to temporary disability of the affected hand, particularly the ability to grip objects.[7]

One hypothesis is that the thumb does not have the dexterity the other four fingers have and is therefore not well-suited to high speed touch typing.[8]

Prevention

Given the way mobile devices are constructed, particularly their small size, most users find it easiest and most tempting to use their thumbs to press the keys. Experts recommend that BlackBerry thumb can be prevented by use of other fingers to press buttons on handheld devices, and varying which fingers are used. They also encourage owners of these devices not to use them for lengthy typing tasks, such as writing lengthy emails, papers, or books.[9]

In the absence of better evidence, such speculative preventative measures risk stigmatizing hand use,[10] which can increase illness behavior as seen in the Australian epidemic of repetitive strain injury.[11]

Diagnosis

Diagnosis is done by an examining physician using Finkelstein's test or by the patient themself using Eichoff's test.

Treatment

Treatment may include:[12]

  • Resting the affected thumb and curtailing or ceasing the use of the device that led to the repetitive strain injury
  • Avoiding gripping objects with the affected thumb as well as any actions that exacerbate pain
  • Reducing swelling by applying ice to the thumb and wrist, taking an NSAID, or corticosteroid injection
  • Immobilizing the thumb and wrist using a splint or brace
  • Seeing a physical therapist for treatment, rehabilitation exercises, and advice on avoiding repetitive strain
  • In serious cases, surgery may be required

Surgery consists of opening the sheath surrounding the affected tendons to release pressure and restore free movement of the tendons.

Another surgical alternative involves a tendon transfer whereby one of the bones at the base of the thumb is removed and a coiled tendon is put in its place as a cushion. For more advanced cases of arthritis, the basal thumb joint can be replaced.[13] However, recovery can be lengthy and outcomes optimal only in patients who have low activity demands on the thumb joint.

An alternative medicine treatment is prolotherapy. Reeves has published a small randomized clinical trial showing some efficacy.[14] Since surgery on small hand joints with severe arthritis can be traumatic with protracted recovery, newer treatments are being developed. Mesenchymal stem cell transplants offer one possible solution for cartilage replacement in damaged joints.[citation needed] Some spas offer massages as a method of cure.[15][16]

Alternative view

The primary issue seems to be a misinterpretation or an overinterpretation of the nociception (pain-related nerve signal) that can accompany arm use.[17] Nociception can stimulate our built-in "pain alarm", alerting us to real or potential tissue damage; however, we learn to interpret and reassign these signals because most pains are false alarms. For instance, in many contexts, activity-related pain is seen as healthy: think yoga or other athletic/exercise endeavors. Common features of activity-related pains that have not received the attention they deserve include stress, job burnout or dissatisfaction, and secondary gain (where a person benefits either directly or indirectly from being ill).[18]

See also

References

  1. ↑
  2. ↑ Nett MP, Collins MS, Sperling JW (2008). "Magnetic resonance imaging of acute "wiiitis" of the upper extremity". Skeletal Radiology 37 (5): 481–83. doi:10.1007/s00256-008-0456-1. PMID 18259743. 
  3. ↑ Koh TH (December 2000). "Ulcerative "nintendinitis": a new kind of repetitive strain injury". The Medical Journal of Australia 173 (11–12): 671. PMID 11379534. 
  4. ↑ Karim SA (March 2009). "From 'playstation thumb' to 'cellphone thumb': the new epidemic in teenagers". South African Medical Journal 99 (3): 161–2. PMID 19563092. 
  5. ↑ Mayo Clinic Staff (1 August 2012). "De Quervain's Tenosynovitis". Mayo Clinic. Retrieved 2012-12-05. 
  6. ↑ Joyce, Amy (23 April 2005). "For Some, Thumb Pain Is BlackBerry's Stain". The Washington Post. Retrieved 2010-04-03. 
  7. ↑ "The Agony of 'BlackBerry Thumb'". Wired.com. 21 October 2005. Retrieved 2010-05-18. 
  8. ↑ "BlackBerry Thumb: Real Illness or Just Dumb?". Arthritis.webmd.com. 26 January 2005. Retrieved 2010-05-18. 
  9. ↑ Gordon, Serena (15 June 2008). "Beware the 'BlackBerry Thumb'". The Washington Post. Retrieved 2010-04-03. 
  10. ↑ Anthony S, Lozano-Calderon S, Ring D (March 2008). "Stigmatization of repetitive hand use in newspaper reports of hand illness". Hand 3 (1): 30–3. doi:10.1007/s11552-007-9052-4. PMC 2528973. PMID 18780117. 
  11. ↑ Ireland DC (June 1998). "Australian repetition strain injury phenomenon". Clinical Orthopaedics and Related Research (351): 63–73. PMID 9646748. 
  12. ↑ Mayo Clinic Staff (1 August 2012). "De Quervain's Tenosynovitis: Treatments and Drugs". Mayo Clinic. Retrieved 2012-12-05. 
  13. ↑ Badia A, Sambandam SN (December 2006). "Total joint arthroplasty in the treatment of advanced stages of thumb carpometacarpal joint osteoarthritis". The Journal of Hand Surgery 31 (10): 1605–14. doi:10.1016/j.jhsa.2006.08.008. PMID 17145380. 
  14. ↑ Reeves KD, Hassanein K (August 2000). "Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy". Journal of Alternative and Complementary Medicine 6 (4): 311–20. doi:10.1089/10755530050120673. PMID 10976977. 
  15. ↑ Jonathan Silverstein (22 December 2005). "Spa Offers Relief for 'BlackBerry Thumb'". ABC News. Retrieved 2010-05-18. 
  16. ↑ "New massage aims to treat "BlackBerry Thumb"". MSNBC. Reuters. 13 November 2006. Archived from the original on 2012-11-04. Retrieved 2013-09-09. 
  17. ↑ Ring D, Kadzielski J, Malhotra L, Lee SG, Jupiter JB (February 2005). "Psychological factors associated with idiopathic arm pain". The Journal of Bone and Joint Surgery. American Volume 87 (2): 374–80. doi:10.2106/JBJS.D.01907. PMID 15687162. 
  18. ↑ Karels CH, Bierma-Zeinstra SM, Burdorf A, Verhagen AP, Nauta AP, Koes BW (August 2007). "Social and psychological factors influenced the course of arm, neck and shoulder complaints". Journal of Clinical Epidemiology 60 (8): 839–48. doi:10.1016/j.jclinepi.2006.11.012. PMID 17606181. 

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