title: Musculoskeletal disorders of the upper extremities due to extensive usage of hand held devices.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Orthopaedic Surgery and Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India.
authors: Deepak
authors: D
authors: Sharan
authors: Department of Physiotherapy, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India.
authors: Mathankumar
authors: M
authors: Mohandoss
authors: Department of Physiotherapy, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India.
authors: Rameshkumar
authors: R
authors: Ranganathan
authors: Department of Physiotherapy, RECOUP Neuromusculoskeletal Rehabilitation Centre, # 312, 10th Block, Further Extension of Anjanapura Layout, Bangalore 560062, Karnataka, India.
authors: Jeena
authors: J
authors: Jose
keywords: Blackberry thumb; Hand held devices; Mobile phones; Myofascial pain syndrome; Tendinosis; Text message injury