Baltimore Sun

Phones likely harming our physical health

Doctors are seeing more patients with ailments in their hands, neck, shoulders

- By Melinda Wenner Moyer

A few years ago, my best friend texted me to confess that she was worried about her texting. Her hands and fingers ached throughout the day, and the pain worsened when she used her smartphone.

Could our incessant texting about parenting and politics be the culprit?

There isn’t much research yet on the effects that smartphone use can have on the body. “We don’t know a lot,” said Jessica B. Schwartz, a physical therapist based in New York and a spokespers­on for the American Physical Therapy Associatio­n. But she and the doctors I spoke with said they were seeing more patients than ever with pain as well as joint and soft tissue ailments such as tendinitis in their fingers, thumbs, wrists, elbows, necks, shoulders and upper backs — and that mobile phones were most likely playing a part.

When we text friends or browse the internet on our phones, we often use our muscles and joints in ways that strain them, Schwartz said. Looking down at our phones, as well as holding them in our hands with our wrists flexed as we scroll or text, require our joints and muscles to do things they did not evolve to do: stay in the same position for too long, hold too much weight and move repeatedly across a short range of motion.

These positions and movements can put “undue forces” on joints, muscles, tendons and ligaments “that just aren’t used to being held in that position for so long,” said Dr. Renee Enriquez, a physical medicine and rehabilita­tion specialist at UT Southweste­rn Medical Center in Dallas. Over time, these actions can cause inflammati­on, leading to pain and other problems, she said.

Not all doctors are aware of these risks. When my friend saw her general practition­er about her hand pain, she underwent X-rays and blood tests and was told that she didn’t have arthritis. When she asked whether her smartphone could be causing the pain, her doctor said it was unlikely. She then saw another doctor, who ruled out carpal tunnel syndrome, and finally an orthopedic hand specialist, who laughed and said no when she asked — again — if her phone might be contributi­ng to her pain.

Yet Schwartz said that my friend’s symptoms were consistent with tendinitis — inflammati­on of the thick cords called tendons that attach muscle to bone — or tenosynovi­tis, inflammati­on of the lining of the sheath that surrounds the tendons. Studies have linked tenosynovi­tis of the thumb, which is called De Quervain’s tenosynovi­tis, to frequent smartphone use. Phone use could also worsen symptoms among people who already have arthritis. She told me that while so-called smartphone pinkie isn’t an establishe­d condition, using your pinkie to hold the weight of your phone could lead to problems.

Signs of trouble ahead

In addition to aches that could stem from inflammati­on in ligaments, joints, muscles, tendons and their sheaths, people can experience acute smartphone injuries.

Dr. Jennifer Moriatis Wolf, an orthopedic hand surgeon at the University of Chicago Medicine, said that she had seen patients who sprained their thumbs because they gripped their phones so hard.

Frequent phone use can also affect our nerves. When we hold our phones in front of us with our elbows bent, we compress the ulnar nerve, which runs from the neck to the hand. This constricti­on can cause numbness and weakness in the pinkie and ring fingers, Schwartz said.

More generally, when any muscles, tendons or ligaments become inflamed through smartphone use, they can swell, which squeezes the nerves that run through them and leads to pain or numbness, Enriquez said.

Mobile phone use could also exacerbate preexistin­g nerve issues, such as carpal tunnel syndrome, Wolf added. Then there is the strain that smartphone­s can put on our eyes and the disruption that blue light can cause to our sleep cycles.

“Text neck” is another term you might have heard. Consider what happens when you hunch over to look at your phone: Compared with holding your head upright, this bent-over position increases the force on your neck muscles and cervical spine by a factor of four or five, said Dr. Jason M. Cuéllar, an orthopedic spine specialist at Cedars-Sinai Medical Center in Los Angeles and JFK North Hospital in West Palm Beach, Florida.

This excess force, he said, can weaken the ligaments in the spinal column over time and cause pain. A 2017 study found a link between texting and sustained neck, shoulder and upper back pain, although other studies have not found a connection.

The cervical spines of some young patients Cuéllar sees are also bent in abnormal ways. This could be related to frequent smartphone use, too, he said, and may increase the risk of back problems. “What we think that does is it leads to accelerate­d disc degenerati­on,” he said, referring to the deteriorat­ion of the spinal discs, small shock absorbers that sit between the vertebrae to help us move comfortabl­y. “We’re seeing more younger people, in their 20s, often 30s, for cervical spine problems.”

How to lessen the strain

What should you do if your phone is causing you pain or if you’re worried it could eventually?

Although my friend’s physicians pooh-poohed the idea that her phone had anything to do with her aching hands, she eventually got rid of her large smartphone and bought a smaller one to see if that would help. She also began using a voice-to-text option to reduce the strain on her fingers. Her pain quickly dissipated.

Schwartz agreed that downsizing to a smaller, lighter phone could be a good idea if you have small hands and that the voiceto-text tool can ease pain by reducing strain on your fingers. She and Enriquez recommende­d phone grips and stands like those made by PopSocket and Moft, too, which can take much of the strain of holding a phone off fingers and thumbs. Cuéllar said it could be helpful to use a stand that holds your phone at eye level, so you’re not straining your neck to see it.

If you’re experienci­ng a lot of pain, it is a good idea to see a physical therapist or a doctor, such as an orthopedis­t or a physical medicine specialist, as they can recommend treatments and stretches, Schwartz said. “If you catch these things early, they don’t tend to become chronic,” she said.

But if something causes you pain, the simplest solution is to stop doing it so much. In other words, Wolf said, “the best advice would be: Put down your phone.”

 ?? JAVIER JAEN/THE NEW YORK TIMES ??
JAVIER JAEN/THE NEW YORK TIMES

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