thumb|Original Nintendo Entertainment System controller, which caused first cases of Nintendo thumb injury

Nintendo thumb, also known as gamer's thumb and similar names, is a form of repetitive strain injury (RSI) caused by excessive playing of video games with the traditional Nintendo controller. This injury mainly occurs due to repeated thumb movements while playing video games. The symptoms can include blistering, paraesthesia (a tingling or a burning feeling in the skin), as well as swelling of the thumbs, though any finger can be affected. This can lead to stress on tendons, nerves, and ligaments in the hands, and further onto lateral epicondylitis ("tennis elbow"), tendinitis (severe swelling of the tendon), bursitis (inflammation of the fluid-filled sac around joints), and carpal tunnel syndrome (compression of the median nerve at the wrist). Similar injuries can occur with other gaming systems, such as PlayStation thumb from playing Sony PlayStation. Nintendo thumb specifically was first highlighted after portable handheld Nintendo games consoles were released in 1989, with reported cases of RSI appearing primarily in children. Later, the controllers for the Sony PlayStation and PlayStation 2 were noted as causing the condition.

thumb|The repetitive motion of the thumb or other fingers on Sony PlayStation controllers can cause the same type of injury as Nintendo thumb.

In 1987, an 11-year-old boy reported to the Children's Hospital of Philadelphia complaining of his finger being contracted, flexed, and being unable to relax it back to its baseline position. After medical investigation it was determined that this same finger was being used to use the joystick of his video game remote (no mention of the brand) up to around 6 continuous hours on a daily basis. All other fingers that did not use the joystick did not witness this injury, and a general approach of anti-inflammatories and eliminating playing time was used to treat this individual.

The first occurrence of the Nintendo thumb condition was published on May 17, 1990, when a 35-year-old woman played a Nintendo video game for the first time. She played it for five hours with no interruptions. The next day, she experienced severe pain in the right thumb (specifically in the extensor tendon), which she had used to press a button on the video game console repeatedly.

In January 1991, the condition was termed as "Nintendinitis" by James Casanova, MD, when he evaluated an 8-year-old boy with pain in his thumb. It was found that the pain occurred when the boy flexed his thumb while playing a Nintendo video game, and that he had no history of trauma or disease.

A similar effect was seen in adults using alternative controllers such as the Nintendo Wii Remote Controller. However, due to the shape, size, and extended use of game controllers, it can occur in users of any gamepad or joystick. Similar problems have also been observed with the use of mobile phones and text messaging in particular, called texter's thumb (see Blackberry thumb).

Reports of nintendinitis resurfaced after the Nintendo 64 console came to market in 1997, which contained a joystick that caused similar injuries in the palm named "ulcerative nintendinitis". These examples of preventative approaches become particularly important since evidence shows that increased video game playing time will increase the risk of developing these conditions. In early 2000, Nintendo of America provided protective gloves for its users after receiving 90 case-reports regarding hand injuries. Nintendo now also provides messages during gameplay to remind players to take a break. After the release of this console in 2006, the first case report belongs to an Achilles heel injury presented by a 46-year-old man after playing performing a jogging motion requested by the game which led to the rupture of his Achilles tendon. A neck-related injury was first reported in 2009 when a 38-year-old man swung his remote control forcefully enough to send him to the emergency department. This injury required a minor surgery to address due to physical therapy being unable to address the individual's symptoms. Additionally, a 44-year-old woman needed surgery to recover from an unstable knee due to a prior anterior cruciate ligament (ACL) tear while playing Wii Sports that failed physical therapy recovery just 6 months prior. While named similarly to Nintendo thumb, the two do not have the same cause. PlayStation thumb is caused by friction and affects the skin (though associated symptoms can include pain and stiffness in the hands, shoulders, and neck),), and epicondylitis (degeneration of the origin of a tendon in the forearm due to overuse of an extensor muscle). and meniscal injury.

Wii shoulder

Wii shoulder is soreness and pain in shoulder and upper extremities, often due to playing games like Wii tennis or bowling. The injury resulted in pain and swelling.

PlayStation thumb

PlayStation thumb is defined, similarly to Nintendo thumb, as a repetitive strain injury (RSI) caused by excessive use of a PlayStation controller. This condition includes blistering of the thumbs due to excessive use of pressure and friction with the PlayStation controller during gameplay. There is also hardening of the skin on the thumb (lichenified hyperkeratotic papules) causing the skin to appear leathery. It can also be accompanied by changes to the nail, such as the nail plate lifting from the skin. Other symptoms include stiffness, swelling, pain, and tingling in the arm joints such as wrists, elbows, and shoulders. Several other cases have been published as well. A study involving 120 students in South Africa followed up on the 2004 correspondence and found that 7 of the 17 girls and 8 of the 28 boys who played PlayStation had symptoms of PlayStation Thumb.

The second case was in 2017 in a 14-year-old boy who had painful palmar nodules after spending prolonged periods of time playing games and using his mobile phone. Similarly to the last case, he had inflammation containing neutrophils in the eccrine sweat glands in his palms. The palmer lesions healed on their own in two weeks after stopping PlayStation gameplay.

See also

  • Video game-related health problems
  • Blackberry thumb
  • Tennis elbow
  • Golfer's elbow

References

Further reading