The Common Cause Behind Wrist Pain While Using a Smartphone

The FitRehab Podcast, Episode 4: The Common Cause Behind Wrist Pain While Using a Smartphone.

Do you have pain in your thumb and/or wrist while using your smartphone? Well you're not alone as this is actually quite common and typically the result of a condition called De Quervain's Tenosynovitis. In today's episode, I'll discuss a recent research study that explored the prevalence of this condition specific to smartphone usage and then I'll discuss what you can try now to alleviate the discomfort while continuing to use your smartphone.

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About Brian Ivy

Managing De Quervain’s Tenosynovitis: Pain While Using Smartphone

Why is your thumb and/or wrist hurting whenever you text or scroll through your phone? De Quervain’s Tenosynovitis is perhaps the most common cause.

What is De Quervain’s tenosynovitis?

De Quervain’s Tenosynotivits is a condition that affects two tendons that control movement of the thumb, especially when operating a smartphone:

1.) Abductor Pollicis Longus (APL)	move thumb out to the side away from palm
2.) Extensor Pollicis Brevis (EPB)	straightens the first knuckle of thumb

Texting like this presents the highest risk for developing wrist pain as it applies the most stress on the APL and EPB tendons.

Both of these tendons reside in a small tunnel in the wrist with a thick ligament that serves as the roof of the tunnel (just like how the carpal tunnel has a thick ligament as its roof, except this is on the side of the wrist instead of the front). 

Both of these tendons also pass through their own individual tunnel (called a sheath) which helps to keep them lubricated to reduce friction as they glide against each other and through the tunnel. When either one of the tendons and/or their sheath becomes irritated, it can increase friction against each other and trigger a vicious cycle of pain and irritation.

Location of Pain for De Quervain's Tenosynovitis

This is a very common injury in today’s society, with the highest prevalence in women between the ages 30 and 50 years of age (Fakoya, et. al.). Recent research suggests this is because of hormonal differences (especially estrogen) that make women more susceptible to inflammation than men , and the associated changes that occur during pregnancy and post-partum (such as joint laxity, fluid retention, and soft tissue edema)(Fakoya, et. al.; Fiat, et. al.; Jeng-Long, et. al.; Shen, et. al.).

Parents of infants and caregivers of infants (such as daycare employees) are also at increased risk for developing this condition due to repetitively lifting with thumbs pointed up.

But, as our world has evolved to where we now do so much from our smartphone, this condition is becoming more common, and thus smartphones have become a new suspect for thumb and wrist pain. So, to look further into this topic, I dived into recent research to see if any has been published that links smartphones to De Quervain’s Tenosynovitis.

In doing so, I came across this study that was published just last in 2023 and I’d like to share it with you today. First, I’ll discuss what the authors of the study reported, and then I’ll share with you my interpretation of the study and results, and more importantly, how I feel you can use the information to continue using your smartphone with less pain and discomfort if you’re experiencing such, and to protect yourself from making the condition worse or to prevent it altogether if you’re not yet experiencing any of the symptoms yet.  

So, without further ado, let’s get to the article. The title of the article is Smartphone usage behaviors and their association with De Quervain’s Tenosynovitis (DQT) among college students: a cross-sectional study in Guangxi, China.

The authors looked at the link between cell phone usage and a positive Finkelstein’s test, which is a test that is commonly used to diagnose De Quervain’s Tenosynovitis. Their study included 937 college students with an average age of 20 years old. Out of these 937 students, just over half (52% of them) tested positive for De Quervain’s Tenosynovitis. 

What they also found was that those subjects that tested positive on the Finkelstein’s test, averaged about an hour and a half to 2 hours more time scrolling through their phone than those that tested negative. 

For the subjects that used their phone for no more than 2 hours per day, 23% tested positive for De Quervain’s. That rate doubled to 46% for participants that used the phone between 4-6 hours per day and more than tripled for those that used it longer than 8 hours per day. But to me, these stats weren’t surprising, as I already suspected that more time doing a repetitive activity, such as scrolling through the phone, would lead a higher prevalence of injury. 

But what was surprising to me though, was to read that there was no significant difference between gender in regard to which subject tested positive and which tested negative for De Quervain’s as women are generally at higher risk for this injury as I explained earlier in this episode.

This study also looked at differences in how the phone is held. 

They concluded the odds for developing De Quervain’s are almost doubled when holding the phone with both hands and using both thumbs (Picture A) to scroll which, of course, isn’t particularly surprising either as you’re essentially developing your chances by using both thumbs instead of one. 

Picture A

What was interesting though, was that there wasn’t much difference in the odds for developing De Quervain’s when considering whether the phone was vertical or horizontal. Just testing it on myself and how I scroll, I would’ve thought holding the phone vertically would’ve lessened the risk as there seems to be less activation of one of the affected tendons when operating it while vertical versus horizontal. But, perhaps that’s just me and how I scroll. And that’s part of the fascinating aspects of research, especially when you have a good sample size. You can really dive into the numbers and learn some things that might challenge you to think more about what you’re doing and telling others instead of solely making decisions based on assumptions.

So what is the safest position to hold the phone?

Well, from this study, it appears as though that would be holding the phone vertically in one hand and using the opposite index finger to scroll (Picture B).

Picture B

The next safest position appears to be holding the phone vertically in one hand and using the opposite thumb to scroll (Picture C), as the prevalence rate was only slightly higher than when using the index finger instead (Nie, et. al.).

Picture C

So, the take-home message that I’d like to leave you with today is that pain in the wrist and/or thumb while using a smartphone appears to be more so dependent on the amount of time spent scrolling through the phone and how the phone is held rather than whether you are male or female.

So finding ways in which you could lessen the overall time you spend scrolling or texting on the phone, might help relieve your symptoms. For example, using the talk-to-text feature, asking Siri to open a page for you or to set a timer, or give you an answer to a question so you don’t have to scroll through pages of results, etc. Really exploring the hand-off features of your phone to limit the repetitive stress on your wrist. Also, try scrolling with your index finger and rest the phone on a surface when doing so, if applicable. If you must hold the phone, try holding it in the opposite hand and scroll with your index finger. Holding and scrolling with the thumb(s) appears to put us at the highest risk for injury.

You could also try using kinesiology tape to relieve your pain. Past clients of mine have reported good relief of pain while wearing the tape. It could become another tool in your toolbox to help you heal and move on from this injury. Watch the video below to learn how to apply yourself.

The specific tape that I used in the video above can be purchased on Amazon by clicking below:

(FYI: The above link will take you directly to Amazon's website. As an Amazon Associate, I earn from qualifying purchases, at no extra cost to you.)

If you found this article helpful, please follow me on Instagram for more helpful tips and resources and to stay updated on when new content arrives.

@fitrehabonline

References

1. Fakoya, A. O., Martin, T., Sabater, E. L., Burgos, D. M., & Maldonado, M. G., I. (2023). De Quervain’s disease: A discourse on etiology, diagnosis, and treatment. Cureus, 15(4) doi:https://doi.org/10.7759/cureus.38079

2. Fiat, F., Merghes, P. E., Scurtu, A. D., Guta, B. A., Dehelean, C. A., Varan, N., & Bernad, E. (2022). The main changes in Pregnancy—Therapeutic approach to musculoskeletal pain. Medicina, 58(8), 1115. doi:https://doi.org/10.3390/medicina58081115

3. Jeng-Long, H., I-Ming Jou, Chao-Liang, W., Po-Ting, W., Ai-Li Shiau, Hao-Earn Chong, . . . Shih-Yao Chen ⨯. (2018). Estrogen and mechanical loading-related regulation of estrogen receptor-β and apoptosis in tendinopathy. PLoS One, 13(10) doi:https://doi.org/10.1371/journal.pone.0204603

4. Nie, X., Huang, L., Hou, J. et al. Smartphone usage behaviors and their association with De Quervain’s Tenosynovitis (DQT)among college students: a cross-sectional study in Guangxi, China. BMC Public Health 23, 2257 (2023). https://doi.org/10.1186/s12889-023-16808-z

5. Shen P-C, Wang P-H, Wu P-T, Wu K-C, Hsieh J-L, Jou I-M. The Estrogen Receptor-β Expression in De Quervain’s Disease. International Journal of Molecular Sciences. 2015; 16(11):26452-26462. https://doi.org/10.3390/ijms161125968

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