Physicians Add Cell Phone Elbow to List of Ills of Digital Age
Talking non-stop on a cell phone? Numbness, tingling and pain in the forearm and hand? It could be Cell Phone Elbow. Known by its medical name of cubital tunnel syndrome, it follows Blackberry Thumb and Wii-itis into the lexicon of painful syndromes of the digital age. Writing about the condition in the May issue of the Cleveland Clinic Journal of Medicine, three physicians at the Clinic speculate that it could proliferate apace with cell phone use around the world.
Michael Darowish, MD, Jeffrey N. Lawton, MD, and Peter J. Evans, MD, Ph.D., explained that in susceptible people, holding the bent-elbow position for extended periods can lead to decreased blood flow, inflammation and compression of the ulnar nerve. This nerve passes along the bony bump inside the elbow. As symptoms progress, they can include a loss of muscle strength, coordination and mobility that can make writing and typing difficult. In chronic, untreated cases, the ring finger and pinky can become clawed.
They describe the condition as the second most common nerve compression syndrome in the upper extremities after carpal tunnel syndrome (CTS).
Dr. Evans, the Director of the Cleveland Clinic’s Hand and Upper Extremity Center, likens repetitive, sustained stretching of the ulnar nerve to stepping on a garden hose. "With the hose, you’re blocking the flow of water,” he said in the June issue of HealthDay News. “With the elbow, you’re blocking the blood flow to the nerve, which causes it to misfire and short circuit."
Cubital tunnel syndrome also lies in wait for people who sit at a computer workstation that requires elbow flexion greater than 90 degrees, according to the Cleveland Clinic team. People who lean on an elbow while driving or working are also at risk. It can affect elderly people who rest their elbows on the arm of a chair or wheelchair. Even people who sleep curled in a fetal position with their elbows overly bent can develop the condition. Simply bending the elbow tighter than 90 degrees for an extended period of time will stretch the ulnar nerve by 8 to 15 percent, according to Dr. Evans.
Ergonomic adjustments to the workstation can help, as well as modifying or avoiding activities known to aggravate the symptoms. The doctors recommend switching hands frequently while talking on the phone or using a hands-free headset.
While severe cases could require surgery, they say, commonsense measures to remove or reduce the risk are generally effective.
Q:What is cell phone elbow, and what should we tell our patients?; Cleveland Clinic Journal of Medicine May 2009 vol. 76 5 306-308; Darowish, Michael MD, Lawton, Jeffrey N. MD, and Evans, Peter J MD, PhD