Digital damage

In an age when we communicate with tiny gadgets, the 'trigger finger' isn't itchy - it's painful

Punching numbers on mobile phones, clicking away at video games and scrolling the dial on a mouse isn’t hard labour, but the muscles in your hand are getting a workout that can sometimes result in long-term injury.
Office worker Suttirut Kasayapakorn, 33, spends many hours each day poking away at her keyboard, mouse, mobile phone and PDA.
“I didn’t have a clue what was happening was when my forefinger first got stuck two years ago,” Suttirut says of the sudden and painful seizing-up of the digit.
She’d never fired a gun, but she had “trigger finger”.
Trigger finger, or flexor tendinitis, stems from irritation in tendons and can cause the finger to pop and click, catch (“triggering”) or lock in position.
Prescription medicine rescued the day for Suttirut, but the stiffness returned two months ago. Her finger doubled in size and she couldn’t move it, and the right thumb was afflicted as well.
The causes of the problem are debatable, but therapists agree that the modern lifestyle is a factor in a surge of cases now appearing. Suttirut just happens to be part of the generation that’s the first to suffer the consequences of fiddling with tiny communications equipment.
It used to be that people went to the doctor because of heavy lifting. Today most people are more specialised in their work – only small groups of muscles are utilised – but that can cause an imbalance that invites hurt.
Bangkok orthopaedic surgeon Pak Thongpak says the number of patients suffering from trigger finger doesn’t seem to have risen over the years, but the chief cause has apparently shifted – from housework to overuse of hi-tech devices.
Pak is Suttirut’s doctor, but though she’s a victim of this technological shift, he says, it’s too early to conclude that such devices will have a long-term impact.
The majority of patients at his practice in the city’s wealthier Silom area are white-collar city workers, so he can’t speak for the country as a whole. But Dr Vichai Vijitpornkul, assistant director of the state-run Lerd Sin Hospital, is dealing mostly with housewives complaining of the affliction.
“One of my patients was speech-impaired and relied on punching text messages on the mobile to communicate,” he says of a rare “hi-tech” case among the more than 8,000 patients he’s treated in the eight years since he introduced a specialised hand surgery.
Among those who have benefited from Vichai’s quick finger-incision technique have been many housewives who carry too many packages while shopping and a man whose job was to punch hundreds of employee cards every day. Then there was the banker who counted money manually for years, and a golfer who shunned gloves while putting.
Dr Vichai does, however, recognise the peril in hand-held devices.
“The smaller the hand-held device, the more risk to your hands,” he says. An adult hand both gripping and manipulating a tiny gadget is bound to start hurting after repeated effort.
If you’re working with anything small – the handle of a golf putter, a pair of scissors – often and for a long time, your hands stiffen.
Trigger finger, says Vichai, can result from a trauma injury or repetitive injury, and harsh effort isn’t necessarily a factor.
The first symptom is a stiff finger, then a snapping or popping sensation as it unbends. Sometimes there is swelling.
At a more serious stage, the finger temporarily locks in place and must be forcibly bent or unbent. If manual effort can’t unlock it, surgery is required.
Physical therapist Khompakorn Limpasutirachata is currently treating a 10-year-old boy whose right thumb is locked.
Although the exact cause remains inconclusive, two years ago the youngster abandoned his PlayStation joystick for a hand-held Game Boy that he always kept handy, even when he started playing online last year.
He’d been experiencing problems for a year but, until last month, had hidden them from his family. Why, he wanted to know, do his friends have no affliction when they play games as much as he does? Khompakorn explained that endurance varies with each individual.
Orthopaedic doctor Sitthiporn Oripin, who works out of a Sukhumvit Road hospital, insists that modern technical devices are not to be blamed.
“The gadgets don’t cause the pain. The symptom has been with humans for decades,” he says.
“If you’re working with a pair of scissors for several hours a day or carrying heavy stuff all the time, you’re likely to have this pain too.”
Trigger finger didn’t show up yesterday – it was just missing a name and a description until Vichai came up with “Niew Lock” several years ago.
Normally, Sitthiporn says, finger joints are covered in symovial fluid, which acts as a lubricant and shock absorber.
As we age, the fluid thins and is less effective.
“Basically, you suffer only because you’re overusing your hands, not because you’re using these gadgets.”
“What you carry home every day is what you should be worried about more,” Vichai agrees. Few people seem to realise that the weight might hurt their fingers.
The pain that Suttirut felt after her daily stroll down the technological superhighway was arrested early with medication. She’s since been using her fingers less and soaks them in warm water each evening.
Beyond the prescription drugs lie hand surgery and physical therapy, but even before the medicine, Khompakorn points out, is exercise.
“Or try to find a hobby or other activity that allows your hands and fingers to be in a position opposite to where they work – that way they’re less likely to get locked.”

Sirinya Wattanasukchai
The Nation