WhatsAppitis: watch out for smartphone abuse

A “WhatsApp disease” becomes more frequent amongst electronic device users

Some medical experts are seeing a rise in cases. In this uncommon phenomenon, thumbs and wrists are overstretched for writing messages, causing sharp pain.

In English-speaking countries it is being referred to as "WhatsAppitis" or "WhatsApp Disease", yet it can still be classified within the realm of so-called Repetitive Strain Injuries (RSI) or Work-Related Musculoskeletal Disorders (WRMSDs). In any case, this is a concrete example of how the smartphone has brought a new, orthopedic disease to civilization. Experts are seeing a strong rise in the incidence of such a phenomenon.

Occupational therapists recommend two-handed typing

"When using the smartphone with one hand, the thumb is overstrained," says Prof. Dr. Stefan Langer, Head of the Department of Plastic, Aesthetic and Special Hand Surgery at the Clinic for Orthopaedics, Trauma Surgery and Plastic Surgery at the University Hospital Leipzig. "This strain increases with the size of mobile phone displays - and with the urge to be constantly on the social networks."

The human thumb has evolved into a designed that aims to support the gripping of the hand. The first closure is a typical move for the strongest finger of the human hand; but, a stretching or spreading movement in the long run, however, is not a common gesture. "The continued thumb movement in the direction of the little finger exerts exertion and leads to pain in the thumb-side wrist," says Prof. Langer. "The typical patient today is 15 to 25 years old, actually very healthy and engaged in social media. In the past, the typical patient profile was female, of around 65-year-old who worked her whole life. Often such cases would indicate wear and tear, which included classic tendovaginitis in the thumb area."

Dilemmas for physicians managing such cases

The difference between today and the past in a patient's age and their general physical constitution is not only statistically interesting but also limits the physicians’ therapy options. "An elderly patient would often receive a cortisone injection, and the pain or inflammation subsided. Only in a few cases, it would have been necessary to operate and open the tendon cavity. I can't give the young cell phone user cortisone with a clear conscience: The patient, and most specifically, the tendon, has its whole life ahead. There may still be real medical problems for which cortisone is indispensable. There's no real reason for surgery either. I can only advise the young patients: Mobile phone off. With a little patience, the pain will go away after a week."

Of course, occupational therapists can also help, such as Norina Weisenbilder from the Central Institute for Physical Therapy and Rehabilitation at the University Hospital Leipzig. The 34-year-old knows the problem: "In every corner I see my future patients standing - head tilted, hunched back and thumb always in motion. In the long run, muscle tensions are the logical consequence. First the big thumb flexor, then the forearm, the shoulder, the neck." Occupational and physiotherapists master techniques with which fascia, muscles, and connective tissue are loosened. Kinesio tape on the thumb saddle joint and on the thumb side of the forearm also helps to stabilize the long thumb flexor.

Strict cell phone ban? Prevention is possible

Ms. Weisenbilder recommends "mobile phone users to use both thumbs at the same time”. The physiotherapist elaborates her case: "This means that thumbs do not have to travel long distances on the display, so they are not overstretched. And in general, mobile phone handling should remain within limits. Then your thumb won't hurt either."

Prof. Langer points out, however, that mobile phone addiction and its medical consequences are also taken into account by general practitioners. "If a young person comes with pain in his hand, it is not necessary to have an X-ray, a CT or even an MRI immediately. An inexpensive ultrasound scan usually reveals the swollen tendon. Also, manual therapy options should not have to be ruled out at first. Sometimes a bit of a break from the artifact is enough. It would be best," the Leipzig surgeon smiles, "if the doctor could pronounce a temporary mobile phone ban...as he or she may do with his own children”.

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