Blackberry thumb pain

My patient, a 56-year-old lawyer, was a self-professed mobile-phone addict. His thumb and wrist pain were worsening daily. By the time I saw him, he was no longer able to punch his BlackBerry. His orthopedist had already diagnosed osteoarthritis, and the patient had been referred to me to rule out nerve damage.

Repetitive-strain injuries can occur when we put our joints through the same repeated action, especially when the action focuses pressure on a particular point. And these days, our fingers are taking a beating. As text messaging becomes increasingly popular, tapping, flicking, and clicking have spawned a variety of hand-related ailments: BlackBerry thumb, iPod finger, Nintendinitis, and Wiinjuries.

Handheld mini keypads are awkward to strike, leading users to create finger acrobatics. Many texters prefer to use their thumbs to type and can build up speed, some reaching rates of about 60 words per minute. "BlackBerry thumb" refers to a variety of hand conditions including aggravation of thumb carpometacarpal joint arthritis, a degenerative condition affecting the thumb's base. Symptoms range from an occasional ache to severe pain with weakness and disability. Diagnosis is based on X-rays and exam findings, which might include pain induced by pressure over the joint, swelling, warmth, and even hyperextension deformity.

As with most repetitive-strain injuries, symptoms result when wear and tear causes damage. Such effects can be greater in older users, who may already suffer from degenerative joint disease and are more predisposed to inflammation and pain.

Excessive use can also lead to a form of tendinitis called "trigger thumb," which involves locking of the thumb's long flexor tendon, and De Quervain's tenosynovitis, in which the tendons at the thumb's base become inflamed. Carpal tunnel syndrome might be associated with these conditions. As with my patient, symptoms might include numbness and tingling of the palm side of the thumb and fingers (except the little finger), as well as wrist pain and hand weakness.

Reports of these electronics-induced conditions have been mostly anecdotal, and it's unclear how widespread the problem is, but physicians are starting to take notice. And with text messaging skyrocketing, more rigorous study is inevitable. A recent Microsoft poll of more than 1,000 U.K. office workers showed that operating mobile devices played a role in many repetitive-strain injuries, including BlackBerry thumb. Of course, the condition isn't unique to the BlackBerry; I use my thumbs to type on my Palm Treo.

My patient was lucky. His nerve tests came out fine, and I heard he eventually improved with some rest.

To steer clear of gadget-related ailments:

• Turn off your device and take tech holidays.
  
• Write shorter and fewer messages and reduce keystrokes using the AutoText feature, if possible.
  
• If you know you have arthritis or joint problems, avoid excessive use.
  
• If you feel strain or pain, stop and rest your hands.
  
• See your doctor if symptoms don't resolve or you develop excessive swelling. Orthopedic hand surgeons usually recommend stretching and applying ice to affected joints and using a properly fitted thumb-stabilizing splint. A short course of anti-inflammatory medicines, such as ibuprofen (Advil or generic), might help.
  
• In severe cases, a cortisone injection may help or surgery might be required.