By Vashni Benjamin Be it a headache, backache, stomach ache, bad grades, or even the common cold, every Sri Lankan mother’s go-to excuse is: “It’s because you’re always on your phone!” Studies now reveal that there may be more truth to her words than you expect. The 21st Century has built a complicated relationship with technology, with its role in our lives being an amalgam of both a curse and a blessing. Smartphone-related physical injuries have grown to become one of the most common as well as most brushed-aside injuries for the simple reason that its only solution – reducing smartphone usage – does not sound appealing (or practical) to many of us. To delve into the complications of the growing issue, we sat down with Physiotherapist Surangi Ranaweera to learn more about the little ways where the extended use of smartphones may affect our lives. “People are quite busy with their smartphones and tablets these days; they use their phones for work, fun, communication, games, television, etc. and therefore, spend prolonged hours engaging in mobile device-related activities. This ‘addiction’ can cause repetitive strain injuries to various small joints of the hands. Continuous scrolling and tapping can cause many serious injuries like inflamed thumbs leading to de Quervain Tenosynovitis, trigger finger and tendinitis of fingers and wrists, degenerative changes in small joints due to overuse/wear and tear, deformities of pinkie fingers due to constantly bending and holding heavier smartphones, hand numbness and pain, both carpal tunnel syndrome (CTS) and cubital tunnel syndrome, and general pain in the neck/shoulder/upper back,” Ranaweera explained. Smartphone pinkie While some orthopaedic surgeons dispute claims of the smartphone pinkie, extended use of your phone can have an effect according to Chartered Physiotherapist and registered Osteopath from Surrey Physio Tim Allardyce, who stated: “In the short term, this (regular use of phones) can cause hypermobility of the small joints around the fingers and thumbs as the ligaments can become slightly stretched. On the longer term, overuse of the fingers and thumbs can cause osteoarthritis as the cartilage degenerates between the joints. When the fingers become arthritic, they tend to form excess bone around the joints which can enlarge and deform the fingers and thumb joints. And less commonly, holding the phone at a certain angle repeatedly for long hours through the day can cause some deviation of the fingers in people with hypermobile joints.” Smartphone pinkie is said to occur when your little finger bends near the first knuckle from the way you hold your phone. “The best way to avoid any deformities is to be careful when you handle the phone; try your best to keep the smart phone on a table or desk instead of lifting it, try to change the position of fingers when holding the phone, and take a few breaks during the period of use,” shared Ranaweera. Tech neck and back pain According to reports by New York back surgeon Kenneth Hansraj: “As the head tilts forward, the forces seen by the neck surges to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees,” with 60 pounds (equivalent to 27 kg) being the average weight of an 8-year-old. Many people have felt intense pain in their shoulder and neck after extended smartphone use. What position should be adapted when using our phones to reduce this damage and/or what we could do to reduce the pain when the pain is experienced are some of the most common questions that hover our minds. “People who are slouched over their phones are putting abnormal pressure on the neck. It can change the alignment of your cervical spine and cause postural hyperkyphosis. Initially it may be limited to neck pain, numbness, and diminished neck movements, but eventually, it may lead to severe nerve root compression called “cervical myelopathy” over time. Forward flexion of the neck can cause unnecessary stress on upper back muscles, and it can range from chronic, nagging pain to sharp, severe upper back muscle spasms. Shoulder pain and tightness can also occur, resulting in painful shoulder muscle spasms. In this case, Ranaweera advices: “You can prevent this by keeping your neck and upper back straight. Remember to take a small rest every 30 minutes and engage in some neck stretching, shoulder shrugging, and protraction and retraction exercises.” Text claw Cramping in the fingers is another common pain that people complain of, after texting for too long. While not texting seems an unlikely solution, changing the way we text in order to reduce this damage may actually help. “Finger cramping and pain is more common in prolonged mobile phone users as they bend their wrist, fingers (especially the thumbs), and elbows for an extended period of time. This incorrect posture can irritate the tendons of small muscles of the hand. Frequently strained small muscle tendons become inflamed, which is why you feel pain and numbness. If left untreated, it may lead to chronic inflammation and affect your simple, day-to-day activities as well,” shared Ranaweera. This extended use can cause repetitive strain injuries, with overuse of your thumbs even leading to conditions like “trigger thumb” and in extreme cases “thumb arthritis”. To minimise the strain on your wrists, Ranaweera advises to: . Avoid constant texting and swiping the phone screen . Try placing the phone on a table while texting . Try keeping your elbow and wrist straight as much as possible . Use your other fingers alternatively for typing instead of the thumb only . Take breaks from constant phone use and stretch fingers, wrist, and elbow . Keep both of your hands in warm water for at least 10 minutes and apply some manipulation techniques such as massaging CTS: Carpal tunnel syndrome/cubital tunnel syndrome “Carpal tunnel syndrome” is a term becoming more frequently paired with smartphone-related injuries. What are some symptoms to say that someone might be experiencing carpal tunnel syndrome? How important is it to get proper medical attention to it? According to Ranaweera, carpal tunnel syndrome is the compression of the median nerve, as it travels through the wrist at the carpal tunnel. “The repetitive action of the wrist may lead to pain, numbness, and tingling in the thumb, index finger, middle finger, and the thumb side of the ring finger. You may need medical attention if the above symptoms are apparent. Nerve conduction studies can confirm the diagnosis,” she added. Another thing to be aware of, she went on, is how the extended use of mobile phones can affect your elbows. She shared that prolonged bending of the elbow involves pressure or stretching of the ulnar nerve, which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. “If you have the above symptoms, it may be the condition called ‘cubital tunnel syndrome’,” she said. Eye damage We’ve heard enough and more about how the blue violet rays emitted from mobile devices are bad for the eyes. The risk of blindness, as a result of these rays, is very high and increased even more, owing to extended exposure. Headaches are a good symptom for effects of eye damage and must be treated very seriously. Dry eyes are becoming another widespread issue due to overuse of smartphones. A Japanese study recently found that exposure to computer screens for over eight hours causes lower mucin levels – a protein that helps tears stay sticky and spread evenly – in the eyes. While dry eyes is not an irreversible condition, when untreated, they can lead to corneal ulcers and scarring. Consultation of an ophthalmologist and getting eye drops if necessary are recommended. “Our bodies and joints are continually degenerating due to ageing, overuse, and wear and tear,” says Ranaweera, adding: “If you are strongly addicted to smartphones, you may even experience osteoarthritis of fingers and the wrist very soon. These neglected minor injuries can at some point lead to more severe conditions such as cervical myelopathy, chronic back pain, severe osteoarthritis of small joints, dupuytren's contracture (permanent bending of fingers), etc.” The following are some hand and wrist exercises that can relieve the stress and reduce the pain, but if pain persists, you can directly consult a physiotherapist or be referred from a GP after relevant investigations.             (Surangi Ranaweera holds a BSc (Special) in Physiotherapy from the University of Colombo. She currently works as a physiotherapist at the Base Hospital, Colombo East and is also a member of the Chartered Society of Physiotherapy in Sri Lanka)