Rx for BlackBerry thumb.(5-MINUTE CONSULT)(repetitive strain injuries caused by excessive use of electronic devices)

MY PATIENT, a 56-yearold 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.

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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 athe 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.

Taking notice

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 ...