As Video Games Become Ubiquitous, So Do Hand Health Problems

In gaming, a few seconds of uninterrupted rest or the simultaneous application of the entire contents of a first aid kit can heal most injuries.  However, the ever-increasing numbers of gamers, their crossing of both age and gender boundaries, and the hours they put into their namesake activity can lead to some real world consequences to their health that can’t be cured with a bottled fairy.

Recent surveys have shown that online gaming, including gaming on PCs and consoles, has grown in the past year to eight hours per week on average, independent of offline or handheld options.  So much time spent on a single activity, even those as seemingly benign as "Farmville" or as active as "Modern Warfare 2", can have a serious effect on the only universal gaming interface, human hands.

Carpal Tunnel Syndrome: What is it?

The bane of Human Resources departments worldwide is a condition known as Carpal Tunnel Syndrome.  The carpal tunnel itself is an open space inside the wrist surrounded by bone and ligament through which the median nerve runs.  The median nerve branches off from the shoulder down the length of each arm and partially controls the motions and sensations of the thumb and fingers.

“Most people initially complain of numbness and tingling in their hands, usually in their ‘radial’ three digits: thumb, index finger and long finger,” reports Orthopedic Surgeon Dr. Dana Tarandy of Woodstock, IL.  “Sometimes it includes the ring finger due to dual innervation with another nerve called the ulnar nerve. Later on, they get severe pain, burning pain, muscle weakness and muscle wasting in a long standing Carpal Tunnel Syndrome case.”

How does it happen?

One of the leading causes of Carpal Tunnel Syndrome is the swelling of the surrounding tendons produced by repeated overuse or poor ergonomics of the wrist.  This includes, but is not limited to, excessive mousing, Wii-mote use or a particularly tight or unconventional grip of a standard gaming controller that puts the wrist in an odd position for any length of time. “If you are gripping or holding your hand at an awkward angle, you should give your hands a break for ten minutes every hour to let that nerve relax,” recommends Dr. Tarandy.

The condition can be managed in a number of ways from moderate to severe.  “A carpal tunnel splint will increase the volume of the carpal tunnel by holding the wrist in relaxed, neutral but a slightly ‘up’ position.  Especially at night, a lot of times at night we tend to go to sleep and our hand bends or flexes downward, and that deceives the volume of the carpal tunnel, putting more pressure on the nerve.”  Anti-inflammatory drugs or physical therapy can also be prescribed.  Surgery to expand the space for the median nerve, known as “carpal tunnel release” surgery, as it severs the transverse carpal ligament but “heals in about two weeks, but you can use your hand right away, a highly successful surgery, a ten minute outpatient surgery with a full or nearly full recovery with almost all symptoms going away.”

Other Possible Problems

Gaming related bone and muscle ailments are not exclusive to the wrist.  In just the past twenty years, the need for fast and accurate finger and, in particular, thumb movement has become essential for both social and virtual survival.  The best example is the number of controller buttons under the purview of a single hand as grown from one in the dawn of the gaming age, to at least seven, in the current era and that’s not counting an analog stick.

Button related actions are not limited to simple presses either.  Critical gameplay maneuvers often require long-term pressure to be applied to one button, e.g. as a stand in for an accelerator pedal; the rapid movement from one button to another in short sequence in rhythm games or quick time events; or the sustained, rapid hammering onto a single button to survive a cutscene or hide a loading screen.  All of these situations result in repeated and stressed action on the joints of the fingers, a contributing (though not solely causative) factor toward the development of Osteoarthritis in the hands.

Osteoarthritis is the blanket term used to cover the process where the breakdown of cartilage between joints causes further damage and complications to movement.  When bones begin to wear against each other they start to heal abnormally, creating bone spurs and other painful complications.  A related arthritic condition concerning the overuse of fingers is known as Trigger Finger.  “A nodule develops in the tendon that gets caught under a ligament,” explains Tarandy, “when you flex it down it gets trapped under a ligament and when you try to extend it, its basically stuck and then you have to manually pull it back.”  It can also be corrected by splinting or surgery.

Overall prevention of Carpal Tunnel Syndrome and various arthritic conditions is part of a laundry list of general wellness information consisting mainly of the moderation of any potentially harmful activity (including gaming sessions), getting regular exercise and eating well.  Any concerns or attempts at treatment should first be cleared with your physician.