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Excessive use of electronic gadgets: Health effects

Article in The Egyptian Journal of Internal Medicine · August 2020

DOI: 10.4103/ejim.ejim_56_19

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 Systemic lupus and extracellular vesicles. Omeran et al.

Structure of the bone marrow niche. Shoieb et al

Prevention of delerium in seniors. Hemeda

Excessive use of electronic gadgets. Sarla

Thyroid hormone changes in pregnancy. Mousa et al

Cyclophilin A as cardiovascular disease biomarker in type 2 DM .Hussain et al

Figure 1: Main cryoglobulin-related extrahepatic
Gestational diabetes in high risk women in Assiut. Ahmed et al
symptoms in cryoglobulin-positive patients.
(Page 461).
Drugs after expiry date. Sarla

NIV training. Elena et al

Evaluation of the Sabadell NIHCED. Kamal et al

Apolipoproteins in the diagnosis of HCC. El Garem et al

Role of different DAA on HCV. Elshazly et al

Serum fibronectin for liver fibrosis. Ghafar et al

Effect of direct-acting antivirals on elastographic measures in patients with

chronic hepatitis C virus infection. Sakr et al
Figure 1: (Frequency of patients without prior
history of diabetes (n=120) according to fasting Value of EUS in prediction of dysplasia in UC. Elrabat et al
blood glucose.) (Page 589).
Detection of fundic varices obturation. Elrabat et al

SVR12 and SVR24 in DAAa therapies. Elsabaawy et al

Osteopontin and portal hypertention. Fouad et al

Predictors of myocardial injury. Shaheen et al

Serum omentin-1 in Crohn’s disease. Mohammed and Omar

H. pylori cagA (+ve) among gastric cancer patients. El Mazny et al

Figure 1:PCR product bands at 557 base pair
(bp) and interleukin-12B gene polymorphism HCV core antigen and SVR. Musa et al
bands at 557, 454 and 103 bp. (Page 809).

Volume 31 Issue 4 October-December 2019

408 Review Article

Excessive use of electronic gadgets: health effects

Gurmeet Singh Sarla
Department of General Surgery, MH Devlali, Mobile phones, internet, social networking sites, and texting have changed the way
Nasik, Maharashtra, India
we see the world. There are ∼6.9 billion mobile users, almost as many as people on
Correspondence to Dr. Gurmeet Singh Sarla, earth. People who excessively use electronic gadgets develop musculoskeletal
MBBS, MS (General Surgery), Senior Registrar, disorders. Repetitive strain injury is a chronic condition that develops because of
159 General Hospital, Senior Advisor Surgery.
repetitive, forceful, or awkward hand movements for prolonged periods leading to
Department of General Surgery, MH Devlali,
Nasik, 422401, Maharashtra, India. damage to muscles, tendons, and nerves of the neck, shoulder, forearm, and hand,
e-mail: [email protected] which can cause pain, weakness, numbness, or impairment of motor control. Eyes,
Received 3 April 2019
neck muscles, arm, and wrist are affected with prolonged use of electronic gadgets.
Accepted 14 July 2019 People who use smartphones excessively, because of their reduced amounts of
Published: 18 August 2020 face-to-face interaction, are likely to have a feeling that their social relationships are
The Egyptian Journal of Internal Medicine
not supportive and rewarding and that they are not actively contributing to the
2019, 31:408–411 happiness and well-being of others. The aim of this review article is to study
literature and list the problems associated with prolonged use of electronic gadgets
and ways to minimize the symptoms owing to increased ‘screen time’. Smartphone
overuse may lead to development of repetitive stress injury or overuse syndrome
thereby affecting hand function resulting in pain in the thumb. Prolonged use of
electronic gadgets may affect the human body adversely. There is a critical need to
promote healthy ways of smartphone use, as well as the importance of friendship
and family connectedness as a way of promoting the psychological well-being.
Physicians should get themselves updated of these new disorders and younger
generation needs to be educated adequately about the ergonomic practices and
health safety of gadget usage.

Keywords:
de Quervain’, s tenosynovitis, electronic gadgets, repetitive strain injury, smartphone,
WhatsAppitis
Egypt J Intern Med 31:408–411
© 2020 The Egyptian Journal of Internal Medicine
1110-7782

The aim of this review article is to study literature and

Introduction
list the problems associated with prolonged use of
Mobile phones, internet, social networking sites, and
electronic gadgets and ways to minimize the
texting have changed the way we see the world. Mobile
symptoms owing to increased ‘screen time’.
phones have made the world as one. It has influenced
relationships and behaviour pattern. A mobile phone
Repetitive strain injury
that was primarily made for calling is now being
People who excessively use electronic gadgets develop
increasingly used for texting, gaming, social
musculoskeletal disorders. Repetitive strain injury
networking, and listening to music. As per a report
(RSI) is a chronic condition that develops because of
by Yoram Wumser, US adults will spend an average of
repetitive, forceful, or awkward hand movements for
3 h, 35 min/day on mobile devices in 2018, an annual
prolonged periods leading to damage to muscles,
increase of more than 11 min. By 2019, mobile will
tendons, and nerves of the neck, shoulder, forearm,
surpass TV as the medium attracting the most minutes
and hand, which can cause pain, weakness, numbness,
in the US.
or impairment of motor control.
There are ∼6.9 billion mobile users, almost as many as
The thumb is the least dexterous of all the fingers and is
people on earth. Such a wide base of mobile phone
not suited for the repetitive movements required to
users has resulted in higher access to the Internet. They
type on a mobile keypad. A smartphone that relies on
have become personal devices that indicate social
the thumbs for repetitive activities like typing can cause
identity and status and provide numerous
injury. WhatsAppitis, a new disorder with the name
gratifications in the form of entertainment,
information finding, time management, coping
strategies, and social identity maintenance [1]. This is an open access journal, and articles are distributed under the terms
of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Research has shown that certain people become so
License, which allows others to remix, tweak, and build upon the work
attached to their device that they experience separation non-commercially, as long as appropriate credit is given and the new
anxiety when it is not with them [2]. creations are licensed under the identical terms.

© 2020 The Egyptian Journal of Internal Medicine | Published by Wolters Kluwer - Medknow DOI: 10.4103/ejim.ejim_56_19
 Excessive use of electronic gadgets Sarla 409

coined by Fernandez-Guerrero [3], was first reported involvement is often reported in new mothers or
in a 34-year-old pregnant woman presented with child care providers in whom spontaneous resolution
bilateral wrist pain. It resulted from an overuse of typically occurs once lifting of the child is less frequent
the mobile text messaging, for more than 6 h, [8]. NSAIDs, corticosteroid injections, splinting with a
exerting ‘continuous movements with both thumbs thumb spica [9], or a wrist brace may be offered as
to send messages’. The woman was diagnosed with treatment.
‘WhatsAppitis’, which involves bilateral extensor
pollicis longus tendinitis of the thumb or injuries Addiction
relating to overuse of the popular social messaging There is a difference between addiction to the internet
application. and addiction on the internet [10]. When a person
uses internet to play poker on his smartphone for
‘PlayStation thumb’ and ‘cell phone thumb’ are a form prolonged periods, it is more appropriately an
of RSI and were reported in 2009 among teenagers addiction to internet because of his addiction to
who used PlayStation for video-gaming and mobile playing poker rather than a smartphone addiction.
phone texting for longer duration [4]. Acute Wiiitis In addictiveness of smartphone games by game
was described in 2007 and was named after Nintendo players, the addiction is to the gaming behavior and
Wii tennis video game, characterized by intense pain in not to the device as a whole. Hence, to use smartphone
the right shoulder which was reported in a 24-year-old for gambling or to engage in other addictive behaviors
male who had a history of playing several hours of should not be confused with a smartphone addiction
tennis video game where the player made repetitive [11]. The same reasoning distinguishes between an
same arm movements affecting his infraspinatus internet addiction and addictions to specific activities
muscle [5]. carried out on the network, with one of the most
prevalent behaviors online being social networking
Today in this era of computers and mobile phones, [12].
there is an epidemic of upper limb pain. Patients report
to the general surgery and orthopedic outpatient Effect on eyes
departments with symptoms of vague pains involving Prolonged use of electronic gadgets causes ‘computer
the arm, forearm, wrist, or fingers and/or thumb. These vision syndrome’ which manifests as eye strain, dryness,
symptoms which were earlier found in musicians have irritation, burning sensation, redness, blurred vision,
been increasingly observed in young adults owing to and double vision [13]. National Eye Institute has
prolonged use of computers, video-games, and mobile recommended that computer users follow ‘the 20-
phones. These symptoms are generally labelled as 20-20 rule,’ which implies that after continuous
tenosynovitis as no pathology has been found in working on a device for 20 min, taking a break for
tendon sheaths at surgery in such patients. 20 s by looking at a distant object 20 feet away along
‘Repetitive strain injury’ or ‘overuse syndrome’ are with frequent blinking of eyes which will reduce
better terms that can be used to describe these dryness and further strain to eyes [14].
symptoms because they are caused owing to overuse
phenomenon of muscle, joints, and ligaments and Neck pain
respond well to rest. Complaints of arm, neck, and shoulder are widely seen
among gadget users and is defined as ‘musculoskeletal
De Quervain tenosynovitis: De Quervain’s complaints of arm, neck, and/or shoulder not caused by
tenosynovitis is named after the Swiss surgeon, Fritz acute trauma or by any systemic disease’. The pain
de Quervain, who first described it in 1895, which mainly results from improper posture or technique in
involves tendon entrapment affecting the first dorsal handling computers. One of the most common causes
compartment of the wrist. Thickening of the tendon is using computer and desk setups that are not
sheaths occurs around the abductor pollicis longus and ergonomically sound [15]. People who work on
extensor pollicis brevis where the tendons pass through computers for prolonged periods should adopt
the fibro-osseous tunnel located along the radial styloid ergonomic measures like good posture, use
at the distal wrist. Pain is exacerbated by thumb ergonomically fit furniture, move for ergonomic
movement and radial and ulnar deviation of the friendly innovative gadget designs and do stretch
wrist [6]. A classical patient of De Quervain’s exercises to reduce strain and discomfort without
tenosynovitis is a mother of newborn who repeatedly affecting productivity. Moreover, they should take
lifts her child with thumbs radially abducted and wrists adequate break whenever possible. There is a
going from ulnar to radial deviation [7]. Bilateral significant association between the number of hours
410 The Egyptian Journal of Internal Medicine, Vol. 31 No. 4, October-December 2019

of work on computers and overall musculoskeletal Acknowledgements

disorders [16]. I acknowledge the Department of General Surgery M.
H. Devlali and Dr. Gurmeet Singh Sarla for providing
Mental health with the details of young adult cell phone users who
Overuse of the smartphone which is commoner in presented with vague pain involving the wrists and
females and young adults, is associated with anxiety, thumb to the outpatient department.
depression, stress, and low self-esteem [17,18]. They
have poor social relationships; thus, they think they Financial support and sponsorship
should be in constant contact with others. Mobile Nil.
phone silence can lead to irritability, sleep
disturbances, insomnia, and digestive problems [19]. Conflicts of interest
Results of a number of studies show that mobile There are no conflicts of interest.
phone radiation causes changes in gene regulation,
auditory and visual problems, increased pressure of
acid on the cornea and lens tissue, headache, heat References
1 Bian M, Leung L. Linking loneliness, shyness, smartphone addiction
sensation in the ears, memory loss, and fatigue [20]. symptoms, and patterns of smartphone use to social capital. Soc Sci
Studies also showed that prolonged use of cell phones Comput Rev 2015; 33:61–79.
2 Cheever N, Rosen L, Carrier LM, Chavez A. Out of sight is not out of mind:
causes brain tumors [21]. Hooper and Zhou [22] in their the impact of restricting wireless mobile device use on anxiety levels
study concluded that behavioral problems followed by among low, moderate and high users. Comput Human Behav 2014;
37:290–297.
the addiction to cell phone use cause stress. Some studies
3 Fernandez-Guerrero IM. WhatsAppitis. Lancet 2014; 383:1040.
have shown a positive correlation between depression 4 Karim SA. From ‘playstation thumb’ to ‘cellphone thumb’: the new epidemic
and anxiety and the amount of sent text messages in a day, in teenagers. S Afr Med J 2009; 99:161–162.
and loss of control and social anxiety [23]. People who 5 Bonis J. Acute wiitis. N Engl J Med 2007; 356:2431–2432.
6 Skef S, Ie K, Sauereisen S, Shelesky G, Haugh A. Treatments for de
use smartphones excessively, because of their reduced Quervain Tenosynovitis. Am Fam Physician 2018; 97:Online. PubMed
amounts of face-to-face interaction, are likely to have a PMID: 30216006.
feeling that their social relationships are not supportive 7 Shuaib W, Mohiuddin Z, Swain FR, Khosa F. Differentiating common
causes of radial wrist pain. JAAPA 2014; 27:34–36.
and rewarding and that they are not actively contributing 8 Stahl S, Vida D, Meisner C, Stahl AS, Schaller HE, Held M. Work
to the happiness and well-being of others. A few studies related etiology of de Quervain’s tenosynovitis: a case-control study
with prospectively collected data. BMC Musculoskelet Disord 2015;
among university students have documented high 16:126.
prevalence of nomophobia (abbreviated form of ‘no 9 Huisstede BM, Coert JH, Fridén J, Hoogvliet P. European HANDGUIDE
mobile phone phobia’) which describes the anxieties Group. Consensus on a multidisciplinary treatment guideline for de
Quervain disease: results from the European HANDGUIDE study. Phys
or feeling of discomfort of losing or being temporarily Ther 2014; 94:1095–1110.
without one’s mobile phones and is thought to be related 10 Király O, Griffiths MD, Urbán R, Farkas J, Kökönyei G, Elekes Z, et al.
to the excessive use of mobile phones [24]. Problematic Internet use and problematic online gaming are not the same:
Findings from a large nationally representative adolescent sample.
Cyberpsychol Behav Soc Netw 2014; 17:749–754.
11 Lopez-Fernandez O, Männikkö N, Kääriäinen M, Griffiths MD, Kuss DJ.
Mobile gaming and problematic smartphone use: a comparative study
Conclusion between Belgium and Finland. J Behav Addict 2018; 7:88–99.
Smartphone overuse may lead to development of RSI or 12 Jeong SH, Kim H, Yum JY, Hwang Y. What type of content are smartphone
overuse syndrome thereby affecting hand function users addicted to?: SNS vs. games. Comput Human Behav 2016;
54:10–17.
resulting in pain in the thumb. Social networking sites 13 American Optometric Association. Computer vision syndrome, 2014.
provide a convenient and stimulating tool to facilitate the Available at: http://www.aoa.org/patients-and-public/caring-for-your-
vision/protecting-your-vision/computer-vision-syndrome. [Accessed on 10
fundamental human need for communication although Apr 2017]
an excessive use of them can provoke certain negative 14 U.S. Department of Health and Human services. National Institute of
consequences. There is a critical need to promote healthy Health. National Eye Institute. Available at: http://www.nei.nih.gov/
healthyeyestoolkit/pdf/HVM10_EBulletin.pdf. [Accessed on 11 Aug 2017]
ways of smartphone use, as well as the importance of 15 Huisstede BM, Miedema HS, Verhagen AP, Koes BW, Verhaar JA.
friendship and family connectedness as a way of Multidisciplinary consensus on the terminology and classification of
complaints of the arm, neck and/or shoulder. Occup Environ Med 2007;
promoting the psychological well-being. Although 64:313–319.
everyone benefits from technology and modern 16 Jacobs K, Baker NA. The association between children’s computer use and
gadgets¸ there is a simultaneous risk associated with musculoskeletal discomfort. Work 2002; 18:221–226.
17 Elhai JD, Levine JC, Dvorak RD, Hall BJ. Fear of missing out, need for
electronic gadgets that may affect the human body touch, anxiety and depression are related to problematic smartphone use.
adversely. Physicians should get themselves updated of Comput Human Behav 2016; 63:509–516.
these new disorders. Younger generation need to be 18 Panova T, Lleras A. Avoidance or boredom: negative mental health
outcomes associated with use of information and communication
educated adequately about the ergonomic practices technologies depend on users’ motivations. Comput Human Behav
and health safety of gadget usage. 2016; 58:249–258.
 Excessive use of electronic gadgets Sarla 411

19 Hassanzadeh R, Rezaei A. Effect of sex, course and age on SMS addiction 22 Hooper V, Zhou Y. Addictive, Dependent, Compulsive? A Study of Mobile
in students. Middle-East J Sci Res 2011; 10:619–625. Phone Usage. BLED 2007 Proceedings. 38. 2007. http://aisel.aisnet.org/
20 Zhao TY, Zou SP, Knapp PE. Exposure to cell phone radiation up-regulates bled2007/38
apoptosis genes in primary cultures of neurons and astrocytes. Neurosci 23 Billieux J, van der Linden M, Acremont M, Cesch G, Zermatten A. Does
Lett 2007; 412:34–38. impulsivity relate to perceived dependence on and actual use of the mobile
21 Mild KH, Hardell L, Carlberg M. Pooled analysis of two Swedish phone? Appl Cogn Psychol 2007; 21:527–537.
case–control studies on the use of mobile and cordless telephones and 24 Yildirim C, Correia AP. Exploring the dimensions of nomophobia:
the risk of brain tumors diagnosed during 1997–2003. Int J Occup Saf development and validation of a self-reported questionnaire. Comput
Ergon 2007; 13:63–71. Human Behav 2015; 49:130–137.

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