Blackberry Thumb

How many text messages do you send every day? Check your next bill to see. The record in my private practice, held by a thirteen year old boy, is 13,000 in one month. That is the equivalent of 433 a day or 27 per hour (assuming you stop to sleep for 8 hours).

Technology has advanced to a level that it may ultimately lead to the elimination of handwriting. Whether you like it or not, text messaging is here to stay and most of us use it daily. A decade ago technology was an expensive commodity limited to few people. The first cellular phones were the size of shoe boxes. Today, everyone is able to complete tasks using their bare hands with devices that previously required a room full of computers and a team of engineers to operate.

Technological progress is measured by the ability of a device to do the same job using half the gadget. Unfortunately, the more miniature the device, the more problems our extremities develop. Advances in technology have led to the acceleration of diseases previously limited to a select few. Hand, wrist and elbow problems used to be problems of arthritics, elderly and assembly line workers.

Until recently a teenager with carpal tunnel was cause for concern and meant that a tumor in or on the nerve needed to be ruled out before proceeding with routine splinting and activity modification. In 2016, I routinely treat children and adults with disorders directly related to overuse of the hands, wrists and elbows.

The problem is twofold. First and foremost, hands are similar to tires on a car. When you drive frequently, quickly and with lots of cargo on board your tires will wear much faster than the Sunday driver cruising on Pacific Coast Highway in her convertible. Fortunately, unlike tires, our hands have the ability to heal and repair given time and rest. Many problems abate after a short vacation from the keyboards, cell phones, pda devices and video games; only to return once the routine has been reestablished.

The second problem is the size of the devices we use. Keyboarding on a computer requires all ten digits. Laptop keyboards are typically smaller and the size of the keys (and spacing between them) is less. PDA’s and cell phones ignore eight of our ten digits and require primarily thumb motion. The thumbs used to be reserved for the spacebar only and now they are the sole digits necessary to text using these high tech tools.

Blackberry thumb is the terminology used to describe an overuse of the thumb secondary to texting. This problem is not new only the name is. Long before the formation of the American Society for Surgery of the Hand people suffered from similar disorders. Blackberry thumb is not a made up problem. Recently text messengers’ thumb has become an acceptable diagnosis in New Zealand. The Australian Herald Sun reported that New Zealand, with a population of 4.2 million people, has about 4.5 million mobile phones in use and more than 28 million text messages are sent every day. The first two reported cases were a thirteen and twenty year old; both female.

This “disease” represents a multitude of problems. The one thing all of these patients have in common is overuse (aka repetitive stress) and inflammation. The end result is swollen, painful joints, tendons or nerves. If you have pain, tingling, numbness or triggering (catching or locking of fingers) then you may have a problem. Don’t be too quick to blame it on a computerized device. The device probably accelerated the onset of these problems. Remember the tire analogy; ultimately all tires will wear out no matter how much you drive.

The diagnosis and treatment for this should be orchestrated by a specialist in hand, wrist and elbow surgery. Physicians with a subspecialty certificate in surgery of the hand are the leading experts on diagnosis and both nonsurgical and surgical treatment of these maladies. The physician will first and foremost rule out other causes of these problems; inflammatory diseases, infections, tumors, congenital disorders and trauma. The hand surgeon will then devise a program individually tailored to the patient. Frequently hand therapists, splinting, ultrasounds, electrical stimulation, heat, ice, anti-inflammatory medications (including fish oil, chondroitin, glucosamine, bromelain, and msm), activity modification and rest are required. Acupuncture may also be an adjunct to traditional western techniques.  Occasionally injections and or surgical intervention are required to eradicate the problem permanently.

Ben Franklin once said “an ounce of prevention is worth a pound of cure”. Preventing overuse in 2016 is not an overwhelming task. Start by minimizing all unnecessary usage of computerized devices; especially miniature gadgets. If you are already experiencing symptoms this is mandatory. When possible speak on the phone and avoid emailing or texting. Pay attention to how you carry out your activities. Correct posture and ergonomic positioning may help. If you are required to type for your job, find the largest keyboard with the biggest spacing between keys so your hands are not working in a cramped space. It is also beneficial to take occasional breaks to stretch your extremities. Perhaps one day computers will respond to thoughts instead of typed commands. Until that happens, take care of your hands.