Texting and Hand Injuries
December 4, 2014 | by Loryn Peterson MD

How much texting is too much?

Research is starting to track how the overuse of hand-held devices correlates with repetitive stress injury in the hands. Nobody has yet offered a numeric threshold above which texting is harmful, but the idea is not too far fetched.

How Texting Irritates Tendons

Texting, gaming, and small screen typing can cause irritation in the tendons which move the thumb.

Coined as 'BlackBerry Thumb,' this phenomenon refers to pain, stiffness and clicking at the thumb tip in proportion to their BlackBerry usage.

The device is typically held in the palm, using one or both thumbs to type. But, the thumb is designed more for stability than dexterity, and repetitive cycles of thumb apposition and reposition generate swelling inside the tendon sheath. As inflamed synovium distends the sheath, it becomes difficult for the tendon to glide smoothly underneath its support straps. This generates a mechanical click, occasionally accompanied by an audible pop.

Treatment for Inflamed Tendons from Texting

Taping, splinting, therapy, and anti-inflammatory medication are occasionally helpful. Cortisone injection is often successful, particularly in early cases.

For more severe cases or those which persist after cortisone, surgery is advised. In a minor ten minute procedure, the tight tendon strap is released and residual inflammation is removed. No cast or splint is needed afterwards. Recurrence is uncommon after surgery, and there are no ill effects from releasing this single tendon pulley.

iPhones and Tensoynovitis

The late Steve Jobs would have been quick to affirm that tenosynovitis has not been correlated with iPhone usage -- yet. However, the ergonomics of touch screens and tactile keyboards are different.

Some people hold the iPhone like a BlackBerry and type with their thumbs, whereas others hold the phone in one hand and use the thumb and fingers on their opposite hand for typing.

Inflammation of the tendons at the thumb base can occur in this scenario, related to the repetitive sideways motion of the thumb and wrist. This condition, DeQuervain’s Tenosynovitis, has a similar pathology whereby the inflamed tendons become too swollen for their sheath, gliding is impaired, and patients report pain and stiffness.

Treatment for Tenosynovitis

Aside from the unpopular advice of activity modification, treatment options include splinting, therapy, cortisone, and surgery. As with BlackBerry thumb, recurrence rates are very low after definitive treatment of DeQuervain’s Tenosynovitis.

Prevention Key for Texting Injuries

Strategies for avoiding texting tenosynovitis focus primarily on reducing the number of thumb motion cycles that are performed.

  • Use abbreviations and shortcuts.
  • Opt for a full size keyboard for responding to at least half of your emails.
  • Use voice-activated applications, such as Dragon, when possible.
  • Try to use fingers instead of thumbs to operate touch screen devices.
  • Take a break and stretch the hands and wrist when pain or swelling becomes a pattern.

If it does not subside, a hand surgeon may help guide you towards other successful treatments. Call 206-860-4430 to schedule an appointment.



Written By: Loryn Peterson MD