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      Musculoskeletal Disorders of the Upper Extremities Due to Extensive Usage of Hand Held Devices

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          The use of hand held devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. While sending a text message or using the controls of the HHD the users need to use their thumb and other palm muscles extensively. The objective of this study was to describe the risk factors and clinical features of the musculoskeletal disorders (MSDs) arising due to usage of hand held devices and to evaluate the effectiveness of a sequenced rehabilitation protocol.


          A retrospective report analysis of 70 subjects, who were diagnosed to have a MSD affecting the upper extremities, was conducted. Medical charts from a tertiary level rehabilitation centre from 2005–2013 were analysed. All the subjects reported pain in their upper extremities following extensive usage of HHD and were examined and diagnosed to have a MSD by an orthopaedic and rehabilitation physician. After the assessment and diagnosis, all the patients underwent rehabilitation using a sequenced protocol.


          All the subjects reported pain in the thumb and forearm with associated burning, numbness and tingling around the thenar aspect of the hand, and stiffness of wrist and hand. 43 subjects had symptoms on the right side; 9 on left and 18 had bilateral symptoms. Correlation was found between hand dominance and MSD. 33 subjects complained of onset of symptoms following extensive text messaging. All the subjects were diagnosed to have tendinosis of Extensor Pollicis Longus and Myofascial Pain Syndrome affecting the 1st interossei, thenar group of muscles and Extensor Digitorum Communis. 23 of the subjects were senior executives, among these 7 were CEO’s of major multinational companies in India. All the subjects recovered completely following the rehabilitation.


          The study concluded that mobile phones and gadgets that promoted the predominant usage of thumb or only one finger while texting or using the controls were associated with a higher prevalence of MSDs. Treatment using a sequenced rehabilitation protocol was found to be effective.

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          Most cited references 14

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          Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: A preliminary study in a Canadian university population.

          The study aims were, in a population of university students, staff, and faculty (n = 140), to: 1) determine the distribution of seven measures of mobile device use; 2) determine the distribution of musculoskeletal symptoms of the upper extremity, upper back and neck; and 3) assess the relationship between device use and symptoms. 137 of 140 participants (98%) reported using a mobile device. Most participants (84%) reported pain in at least one body part. Right hand pain was most common at the base of the thumb. Significant associations found included time spent internet browsing and pain in the base of the right thumb (odds ratio 2.21, 95% confidence interval 1.02-4.78), and total time spent using a mobile device and pain in the right shoulder (2.55, 1.25-5.21) and neck (2.72, 1.24-5.96). Although this research is preliminary, the observed associations, together with the rising use of these devices, raise concern for heavy users. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.
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            Excessive texting in pathophysiology of first carpometacarpal joint arthritis.

            A Case with isolated pain and swelling at the base of the left thumb is reported. The problem had lasted for 2 years, and it was getting worse with increasing pain also at the base of the right thumb. The X-ray showed a subluxation and an arthritis of the first CMCJ was diagnosed in left hand. An excision arthroplasty was successfully carried out. The excessive mobile phone use with active texting had been probably the main cause of the problem. Many, especially youngsters use their phones to text and play games a lot. The purpose of this report is to make the researchers and practitioners aware of this problem and to encourage them to record these cases that may be common in future.
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              Thumb joint movement and muscular activity during mobile phone texting - A methodological study.

              The extended intensive use of mobile phones and other devices for Information and Communication Technology (ICT) could expose the thumbs and fingers to operational stresses beyond their intended function which may generate pain and musculoskeletal disorders in the thumbs and the associated joints. Studies characterizing biomechanical exposures associated with mobile phone use are limited to date and the use of electrogoniometry and EMG was assessed for characterizing thumb-based activities.

                Author and article information

                Ann Occup Environ Med
                Ann Occup Environ Med
                Annals of Occupational and Environmental Medicine
                BioMed Central
                6 August 2014
                : 26
                : 22
                [1 ]Department of Orthopaedic Surgery and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India
                [2 ]Department of Physiotherapy, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India
                Copyright © 2014 Sharan et al.; licensee BioMed Central

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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