The Foundry Orthopedics & Sports Medicine Blog

Blackberry Thumb

  

 delicious  

  

The term blackberry thumb was created in the modern media to describe a painful condition in the thumb and wrist which may be associated with overuse of a blackberry, smart phone or other type of hand held mobile device. While it is not a true medical diagnosis, blackberry thumb has gotten a lot of attention in the past few years because of the increasing number of reported cases.

Many people today would be completely lost without their blackberry, smart phone or Personal Digital Assistant (PDA). Between surfing the web, text messaging and checking their email or daily calendars, hand held mobile device users type away on their devices multiple times an hour throughout the day. Text messaging for some is now the preferred form of communication.  It has been reported that the average adult sends or receives over 500 messages per month. Teenage and young adult text messaging estimates are much higher - reported to be between 80 and 100 messages a day. That is a lot of repetitive hand and thumb use.

Blackberry thumb is a repetitive stress injury (RSI).  Its symptoms can include any or all of the following:
• A pain or ache at the base of the thumb, the thumb itself or in the wrist or hand which can radiate into the forearm.
• muscle tension in the muscles at the base of the thumb or in between the thumb and index finger
• swelling and stiffness in the wrist, hand or thumb
• numbness and tingling in the hand or thumb

These symptoms can come on suddenly or appear slowly and get worse over time. They can continue long after the thumb has been used for typing. In some cases the symptoms increase to the point where even normal activities become difficult to perform without pain.

Using your thumb to type on a hand held electronic device has its own unique issues. As anyone who texts regularly knows it seems to be more efficient to text with the thumb in the hand holding the hand held device or using both thumbs to type. However, the thumb is designed very differently than the fingers, its purpose is to work with the fingers to grasp and pinch things. It does not have nearly the amount of dexterity as the fingers do. Using the thumb to type on a small key board or touch screen puts excessive stress on it due to the unnatural posturing required to complete the task. The more frequently this awkward position is repeated, the more stress on the thumb. Over time, this repetitive stress can cause the symptoms of blackberry thumb to occur.

One of the easiest solutions to alleviate some of the stress in your thumb is to try and use a finger to type; your fingers are designed to perform tasks like typing. Periodically stretching out your hand will help with the stress in your thumb and hand caused by the combined actions of typing and grasping the device repetitively throughout the day. 

Due to the ever increasing use of hand held electronic devices such as the blackberry, in June of 2010 the American Society of Hand Therapists (ASHT) reissued their national consumer education alert concerning heavy use of hand held electronic devices leading to overuse injuries. This alert gave examples such as carpel tunnel syndrome and tendonitis of the wrist or thumb as possible repetitive stress injuries (RSI’s) which can occur from overuse.

In their alert ASHT outlined usage guidelines for hand held electronics which include:
1.  Use a neutral grip when holding the device. A neutral grip is when the wrist is straight, not bent in either direction (not bent up or down).  This allows the wrist to move in a way where more motion is available (side to side).
2.  Take frequent breaks or switch to another activity at least every hour. Give your hands a break!!! Overusing the muscles in your hands with repetitive motions, such as pressing buttons or a touch screen makes them fatigued. The muscles in your hands need to rest and recover before being used again.
3.  If possible, place pillows in your lap and rest arms on pillows. This will allow you to keep your head in a more upright position and therefore decrease neck strain. The pillows will help support the arms so they do not have to be held up in the air. At the very least place the device on a tabletop so you are not stressing your arms and shoulders too much by holding the device up in the air.
4.  Sit in an appropriate chair while using the device. Using a chair that allows you to put your feet on the floor and also provides good back support will reduce the stress on your back and shoulders.  Hunching over your electronic device is not good for any part of your body. Think posture.
5.  Switch hands frequently. This is one of the most important things you can do to avoid an RSI from overuse. Disperse the work load. It will allow each hand to rest while the other is being used and will reduce overall fatigue.
6. Frequently focus on a distant object (away from the screen) this tip will help reduce eye fatigue from staring at a small screen for long periods of time.

Note: If your symptoms are persistent and rest and activity modification do not resolve them, you should seek the care of a physician who is a specialist in the treatment of the upper extremity and hands.

For more information concerning hand injury prevention techniques visit: http://www.asht.org