Texters beware: Future messages to those on your contact list may be in danger if you ignore pain in your thumbs, fingers, wrists or elbows.

Repetitive stress injuries – or RSI – of the thumbs, wrists and elbows have received much attention lately, thanks to the increased use of smartphones and tablets, according to orthopedic surgeon Roberto Miki, M.D., who specializes in hand surgery primarily at West Kendall Baptist, Doctors, South Miami and Baptist Hospitals.

“We saw a spike in hand injuries, especially of the thumb, when small keyboards with standard buttons, like those on cellphones, first came out and texting started becoming popular,” he said.  “Smartphones and tablets, now, no longer require pressing of actual buttons, which has helped decrease these injuries.”

Dr. Miki says that the most common injuries he sees are carpo-metacarpal (CMC) arthritis, or basal joint injuries, which affect the thumb; carpal tunnel syndrome, which affects the wrist; and cubital tunnel syndrome, which affects the elbow.  With CMC arthritis of the thumb, underlying joint damage leads to pain when the joint is used repetitively or with excessive force.   With carpal tunnel and cubital tunnel syndromes, ligaments press down on nerves, leading to discomfort or pain, numbness and sometimes permanent damage.

But, he says, there’s a myth that these injuries are caused by the devices themselves.

“It’s not the device that causes these injuries,” he said.  “It’s the way we use them.  If you’re using a smartphone or tablet for long periods of time with your elbows bent beyond 90 degrees or your wrists flexed, you’ll likely experience some discomfort.”

He also suggests that underlying problems like diabetes, which can lead to  swelling around the nerves and nerve damage, and a family or personal history of these types of nerve problems increase a person’s chance of developing an injury related to smartphone or tablet use.

Dr. Miki offers tips to prevent these types of injuries:

•    If you need to talk on the phone for long periods at a time, get a headset or hands-free device that allows you to move your hands.
•    Avoid bending your elbows beyond 90 degrees.
•    When reading from a tablet, use a stand, so you don’t need to hold the device.
•    Follow good ergonomics in general.

If you’ve already begun experiencing problems, Dr. Miki recommends seeking medical attention to prevent permanent damage.

He says that if stopping the activity alleviates the problem, the tips above will help.  But, if a person experiences persistent numbness, pain or weakness, treatment is necessary.

“Bracing usually helps most patients,” he said.  “We usually recommend doing that at night first, then during the day, too, if necessary.  If that doesn’t help, we may give a steroid injection into the affected joint.”

When these steps don’t offer relief, Dr. Miki says diagnostic testing using electrical shocks, known as an electromyography and a nerve conduction velocity test, may be ordered to determine if the nerves are damaged and surgery is needed.

In surgery, Dr. Miki must cut the ligaments surrounding the affected nerve to relieve pressure on the nerves.  If the damage to the nerves is not so extensive that muscle wasting, or atrophy, has set in, surgery usually reverses the damage.

“Our bodies are not meant to function in certain positions, so it’s important to pay attention to how your fingers, hands, wrists and arms are positioned during activities like texting, typing, talking on the phone and working,” he said.  “And if you experience numbness, tingling or pain, seek medical attention.”


The most serious injuries related to texting are those that result from texting and driving.

A new law in Florida went into effect on October 1 and aims to cut down on serious accidents caused by distracted drivers reading and responding to text messages behind the wheel.  Violators will only be fined if they break another driving law, such as speeding.

Baptist Health is a proud sponsor of the Florida Department of Transportation’s Put It Down awareness campaign and West Kendall Baptist Hospital has joined forces  with businesses in that community, to reduce the number of texting-and-driving-related injuries.

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With internationally renowned centers of excellence, 12 hospitals, more than 27,000 employees, 4,000 physicians and 200 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties, Baptist Health is an anchor institution of the South Florida communities we serve.

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