What Is Gamer’s Thumb?
Gamer’s thumb is a colloquial name given to a condition medically known as De Quervain’s Tenosynovitis. A condition not exclusive to Gamer’s but also relatively common amongst musicians and during pregnancy as well as postpartum in breastfeeding mothers. Onset is most commonly associated with chronic overuse of the thumb and wrist more so that trauma, seldom being the result of any specific accident or incident. More often than not De Quervain’s Tenosynovitis is related to repetitive loading of the thumb, such as can occur as a result of excessive time spent playing computer games (hence the condition is occasionally referred to as Gamer’s thumb).
Given that online gaming is a billion dollar industry where Gamer’s will often spend hour upon hour playing. Frequently without taking a break, repeated day after day (or night after night) it is easy to see that if someone is spending hours a day hunched over a keyboard (or console) frantically moving their thumbs and fingers that tissue overload in the hand becomes a real risk. Particularly if employment requires similar postures and actions then the day job and recreation are both contributing to this tissue overload increasing the risk of developing De Quervain’s Tenosynovitis. If someone’s work and hobbies have them adpoting these postures then it is quite likely that thumb pain isn’t going to be the only issue they are confronted with. Back and neck pain, eye strain are other exceedingly common complaints associated with gamers where often again similar to the thumb pain, the onset of these back and neck pain or eye strain symptoms are typically of a gradual onset.
Thumb Tenosynovitis Is Not Just A Gaming “Injury”
With regard to thumb pain and new mothers the constant lifting, patting, feeding, carrying… associated with being a new mother can cause a sudden overload to the tendon complex. This load often goes from zero to one hundred for new parents overnight with little if any time for tissues to adapt to their new roles and duties. Accompany this sudden dramatic change in activities with limited sleep, rest time for self care and associated hormonal changes… it is therefore not surprising that new mothers are quite prone to developing gamer’s thumb pain without going near a console.
Similar to most tendon complaints De Quervain’s Tenosynovitis is most commonly seen in individuals aged 30-50 years old. Around these decades tendons are typically less tolerant of loading changes and more reactive prone to painful flare ups. This fits in fairly nicely for the new mother cause of gamer’s thumb but the actual gamer’s presenting with thumb pain are often younger than this. In these situations it would be suspected that there has been a dramatic overload to the tendon complex through substantial time gaming far beyond the individuals norms.
Some other suggested causes of tenosynovitis of the thumb include:- Inflammatory arthritic conditions such as rheumatoid arthritis is a suggested cause of an individaul developing De Quervain’s tenosynovitis related thumb pain.
- Sufferring a direct impact blow to the wrist or tendon. Although this is an uncommon cause trauma such as this may create a local inflammatory situation in the tendon – tendon sheath complex from direct impact causing pain. Otherwise post-traumatic scar tissue may lead to restrictions in the movement of the tendons in the tendon sheath and potentially creating vulnerability to aggravation.
Anatomy Of The De Quervains Tendons?
Visually the tendons associated with De Quervains tenosynovitis can be easily seen when moving your thumb away from your index finger. Doing this action Extensor Pollicis Brevis and Abductor Pollicis Longus tendons “pop out” near the “palm” side of the base of the thumb. It is this area that is the location where gamer’s thumb pain is felt. This is also the area where in some individuals with tenosynovitis of these tendons will notice swelling and/or creaking here and extending further up the arm into the back of the lower forearm.
The standard site of pain experienced with gamer’s thumb is where the Abductor Pollicis Longus and Extensor Pollicis Brevis tendons cross over the wrist at the base of the thumb. These two tendons are surrounded by a synovial sheath, the purpose of the sheath is to provide lubrication and nutrition to the tendons whilst reducing friction to the tendons assisting them in moving freely and avoiding irritation as they pass across the moving joints at the wrist. Gamer’s thumb pain is considered to be the result of irritation of the synovial sheath surrounding the tendons. Chronic overuse of the thumb from repetitive grasping, gripping, pinching, clenching and wringing actions can overload this tendon and its’ protective sheath. Which can contribute to the onset of pain and potentially cause swelling and thickening in and around this tendon- tendon sheath complex.
If you suspect you have gamer’s thumb or simply have thumb pain then our physio team in Randwick are experienced in helping treat a wide variety of wrist and hand pain including De Quervains tenosynovitis regardless of the cause.