Technology is a pain in the hands

Punching BlackBerries, scrolling iPods and clicking video game controllers is keeping a new generation of hands hard at work and play.

But as students, professionals and video gamers tap away, hand specialists say aging users are more likely to experience pain in joints and digits.

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 successful surgery last year to restore motion in his right thumb. "I used video games, the BlackBerry ... but the cell phone and text messaging was a major problem. On the cell phone, 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."

While experts don't agree on how widespread the problem is, they do agree there has been an increase in office visits by adults.

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

"The trend does seem like there is an increase, with most people using BlackBerries, iPods, PlayStations and keyboards," said Pruzansky, assistant clinical professor of orthopedic surgery at Mount Sinai School of Medicine in Manhattan. "We are seeing more injuries with all the electronic gadgets where you have a lot of digital manipulations. And, with the pain, there is reduced productivity and the increased likelihood of surgery."

But Dr. Keith Raskin, a hand surgeon at NYU Medical Center and Silberberg's doctor, said it was too early to determine what the long-term impact 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 said 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."

In 2004, there were 402,700 musculoskeletal disorders, averaging about 10 lost work days a year, an increase from 399,722 in 2001, according to the Bureau of Labor Statistics.

Raskin said he believes "the frequency and duration of use is causing us problems in our hands."

Glenn Potolsky, 38, an investment banker who uses a BlackBerry, said that 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.

"It is my understanding that this stuff came from a genetic predisposition, but using devices may have complicated the situation," Potolsky said. "Whether there could have been some therapy early on to mitigate the problem, maybe, but I didn't address it for too long to know. I feel great, and absolutely I will continue to use my BlackBerry."

Dr. Robert Szabo, a California-based hand surgeon, said most people affected already 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 the University of California at Davis. "If you had back pain and you sit in a big, low, soft sofa and try to get up, your back hurts more, but the sofa didn't cause the problem."

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, which an estimated 3 million people use for mobile phone and text messaging services with the tap of a finger, 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. "Basically it is just an overuse thing. If you use your thumb to type over and over again, people get pain in their thumbs."

Silberberg said the pain is real. In May, he had a second surgery on his left thumb.

"I was overcompensating because I was scared I would hurt my right thumb again," said Silberberg, a recent Brooklyn Law School graduate. "Both thumbs feel fine now."