Nintendo thumb, also known as gamer's thumb and similar names, is a form of repetitive strain injury (RSI) caused by excessive playing of video games with the traditional Nintendo controller. This injury mainly occurs due to repeated thumb movements while playing video games. The symptoms can include blistering, paraesthesia (a tingling or a burning feeling in the skin), as well as swelling of the thumbs, though any finger can be affected. This can lead to stress on tendons, nerves, and ligaments in the hands, and further onto lateral epicondylitis ("tennis elbow"), tendinitis (severe swelling of the tendon), bursitis (inflammation of the fluid-filled sac around joints), and carpal tunnel syndrome (compression of the median nerve at the wrist). Similar injuries can occur with other gaming systems, such as PlayStation thumb from playing Sony PlayStation. The general recommendation for the treatment is to rest and stop the repetitive motion of the affected finger (usually the thumb). In more severe and painful cases, using NSAIDs is also recommended. Other less localized injuries in the shoulder, knee, and Achilles tendon have also been noted to arise from playing the Nintendo Wii. Some of the symptoms can be associated with the De Quervain syndrome (degeneration of tendons that control the movement of the thumb).
Background Few case reports of symptoms including stiff and painful joints and limited range of motion in the wrist after frequent Atari 2600 use were published in the late 1970s and early 1980s. Nintendo thumb specifically was first highlighted after portable handheld Nintendo games consoles were released in 1989, with reported cases of RSI appearing primarily in children. Later, the controllers for the Sony PlayStation and PlayStation 2 were noted as causing the condition.
In 1987, an 11-year-old boy reported to the Children's Hospital of Philadelphia complaining of his finger being contracted, flexed, and being unable to relax it back to its baseline position. After medical investigation it was determined that this same finger was being used to use the joystick of his video game remote (no mention of the brand) up to around 6 continuous hours on a daily basis. All other fingers that did not use the joystick did not witness this injury, and a general approach of anti-inflammatories and eliminating playing time was used to treat this individual. The first occurrence of the Nintendo thumb condition was published on May 17, 1990, when a 35-year-old woman played a Nintendo video game for the first time. She played it for five hours with no interruptions. The next day, she experienced severe pain in the right thumb (specifically in the extensor tendon), which she had used to press a button on the video game console repeatedly. In January 1991, the condition was termed as "Nintendinitis" by James Casanova, MD, when he evaluated an 8-year-old boy with pain in his thumb. It was found that the pain occurred when the boy flexed his thumb while playing a Nintendo video game, and that he had no history of trauma or disease. A similar effect was seen in adults using alternative controllers such as the Nintendo Wii Remote Controller. However, due to the shape, size, and extended use of game controllers, it can occur in users of any gamepad or joystick. Similar problems have also been observed with the use of mobile phones and text messaging in particular, called texter's thumb (see Blackberry thumb). Reports of nintendinitis resurfaced after the Nintendo 64 console came to market in 1997, which contained a joystick that caused similar injuries in the palm named "ulcerative nintendinitis".
Treatment and prevention It is known that movements that are both high in acceleration and in force can lead to injury if performed repeatedly, and this applies to both larger limbs such as legs and arms, as well as smaller ones such as wrist and fingers. Evidence based guidelines for wise use of e-games by children suggest prevention of musculoskeletal injuries via minimization of usage of e-games that require movements that can lead to RSI while at the same time being mindful of the physical position the player is in while engaged in video games. Additionally, preventative measures can include flexion and extension stretches in the wrist at warm-up and throughout gameplay. These examples of preventative approaches become particularly important since evidence shows that increased video game playing time will increase the risk of developing these conditions. In early 2000, Nintendo of America provided protective gloves for its users after receiving 90 case-reports regarding hand injuries. Nintendo now also provides messages during gameplay to remind players to take a break. The pain and discomfort resulted from this injury is usually temporary, and the recommended treatment includes holding back on playing video games for several days. The few published case reports of Nintendo thumb did note that symptoms resolved upon stopping video game use. Using nonsteroidal anti-inflammatory drugs like Ibuprofen to relieve the inflammation from the RSI is another treatment option.
Other related injuries
Case reports Although overall video game consoles and remote controllers have moved towards a more ergonomic approach, Nintendo has faced an increase in injuries with their consoles caused by the Nintendo Wii. This is because of its novel style of play which involves more physical and interactive activity on behalf of the user. After the release of this console in 2006, the first case report belongs to an Achilles heel injury presented by a 46-year-old man after playing performing a jogging motion requested by the game which led to the rupture of his Achilles tendon.
… excerpt ends here. Continue reading the full article.
