Staying in touch can be a real pain


Punching BlackBerrys, scrolling iPods and clicking video game controllers are keeping a new generation of hands busy, but it’s the old hands that are more likely to experience pain.

At 30, Justin Silberberg is part of the generation that spent countless hours outside of work surfing the Web, scrolling an iPod, text messaging on a BlackBerry and playing video games.

“It started out as a sore right wrist, but then I couldn’t touch my palm with my thumb -- that’s how inflamed it had gotten,” said Silberberg, who had surgery last year to restore motion in his right thumb. “I used video games, the BlackBerry ... but the cellphone and text messaging was a major problem. On the cellphone, in order to get the letter C, you have to strike it three times, so you are hitting anywhere from three to four keys, which is significant.”


Dr. Mark Pruzansky, a Manhattan-based hand surgeon, said overuse of the popular hand-held devices could cause thumbs and wrists to throb, and in some cases irritate existing arthritic ailments and tendinitis.

“We are seeing more injuries with all the electronic gadgets where you have a lot of digital manipulations,” said Pruzansky, assistant clinical professor of orthopedic surgery at Mount Sinai School of Medicine in New York.

But Dr. Keith Raskin, a hand surgeon at NYU Medical Center in New York and Silberberg’s doctor, said it was too early to determine what the long-term effect would be on the wrists, hands and fingers of the first generation of people to grow up in the Information Age, logging thousands of hours of use even before entering the workforce.

Raskin says he rarely sees young patients suffering from “BlackBerry thumb,” trigger finger or carpal tunnel syndrome. “Normally joints are covered in a healthy, viscous fluid called synovial fluid, which acts as a lubricant and shock absorber, but with aging, the fluid thins and is less effective,” Raskin said. “The kids are more tolerant. The kids are less common, but the adults have older joints.”

Glenn Potolsky, 38, an investment banker who uses a BlackBerry, said he had pain in his arms and wrists for several years before opting for endoscopic carpal tunnel surgery, when physical therapy didn’t alleviate the numbness in his fingers. He had operations on both wrists in 2004 and last year to relieve pressure on the median nerve. He also had surgery in each arm for cubital tunnel syndrome, which causes numbness and tingling in fingers.

Dr. Robert Szabo, a Sacramento-based hand surgeon, said most people affected have arthritis or some predisposed medical ailment that using the fingers in certain ways can irritate. “The BlackBerry does nothing to create disease or the medical problem and neither does the computer,” said Szabo, professor of orthopedics at UC Davis.


Upper-extremity injuries such as carpal tunnel cost billions annually in lost productivity, according to a 2001 report on musculoskeletal disorders in the workplace co-sponsored by the Institute of Medicine.

Still, the hand-held devices are popular. The BlackBerry, used by an estimated 3 million people for phone and text-messaging services, has spawned its own pop-culture symptom name, “BlackBerry thumb.” Treatment includes rest, splints and in severe cases, surgery.

“I don’t see it as often as you would think, but many have a problem significant enough to drive them into the doctor’s office,” said Dr. Robert Strauch, associate professor of clinical orthopedic surgery at Columbia University Medical Center in New York. “Basically it is just an overuse thing. If you use your thumb to type over and over again, people get pain in their thumbs.”