Excessive cell phone use during lockdown leading to neurological and orthopaedic issues in elderly and children :  Dr Himanshu Tyagi

2020 has been a year of rare challenges. We have seen an unprecedented diseases like Covid-19  and an unheard measure like lockdown. This situation is particularly dreaded on our elderly population and children, not only in terms of infection susceptibility but also when it comes to adjusting with the lockdown. Medically today we are faced with the different challenge where spectrum of new diseases are coming upfront because of the lockdown. At the forefront of this disease spectrum are conditions associated with increased cellphone use, specially in our elderly Indian population and children.

In the recent past there has been a lot of emphasis on mental health and behavioral changes secondary to home confinement because of lockdown.

Now as we are nearing the end of lockdown, we are seeing a sudden upsurge in the incidences of a number of physical ailments making it clear that If the lockdown era belonged to mental ailments,  post lockdown era will belong to physical ailments.

Many of these physical ailments are a result of excessive cellphone use during this lockdown period, which can be very well concluded from the fact that average daily mobile use increased by almost 4 to 6 times in elderly and 2 to 4 times in age group below the age of 18 years.

Also as per the internet service providers the daily usage of internet increased by 4 fold in rural areas and up to 6 times in urban settlements.

But this excessive cellphone use has come with its own implications on health. The health problems because of excessive mobile use can be broadly classified into two categories orthopaedic & neurological.

Few of the most common Orthopaedic ailments which have taken a center stage in last 2 months due to excessive mobile use are –

1) Neck text syndrome :
Neck pain, slip disc and nerve pain radiating down the arm . This is the most common condition because of cell phone use. This is due to continuous forward bend position of neck during typing or using the mobile which increases the pressure on the the intervertebral disc and causes impingement on the nerve.

2) Smartphone thumb (base of thumb arthritis):   This is due to do excessive use of thumb during scrolling and typing on mobile. This condition particularly affects the thumb of dominant hand and most commonly seen in elderly population above age of 70 years.

3) Dequerveins tenosynovitis : Wrist tendon swelling & inflammation due to holding the phone for long hours in steady position.  

4) Carpal tunnel syndrome : Nerve compression at the wrist due to long continuous holding of mobile in awkward position. Specially seen in elderly females.

5) Tennis elbow : pain over the outer aspect of elbow due to fatigued long muscles of arm while holding the mobile in one position. Specially seen in elderly females.

6) Mid back or upper back pain due to poor sitting posture (continuous forward bend posture). Specially seen in children below the age of 10 an elderly about the age of 70. Commonly associated if mobile use is more than 4 hours a day. Seen commonly in adolescents with poor muscle strength or lack of exercise. Often associated with Vitamin D deficiency and lack of exercise.

7) Chronic fatigue syndrome of upper back & shoulder (clinically known as Trapezitis). Seen in elderly population due to prolonged holding of mobile in unsupported position, like holding the mobile when lying in bed.

8) Student’s elbow or olecranon bursitis : Swelling and pain over elbows due to holding the cellphone for long hours while entire body weight is supported over elbow (as while sitting over table or desk) Seen in  children below the age of 18 may become painful as well.

Talking about the top neurological problems due to excessive cellphone usage are –

1) Irritability, poor concentration and aggressiveness: This is specifically seen in adolescents who are spending long hours playing online games which requires quick reflexes or are competition oriented.

2) Headache – Due to excessive tension in eye muscle while focusing on mobile screen, specially if  placed closer than 10 inches. A lot of adolescence are facing this problem these days.

3) Eye strain – Common in children. Specially in those children who are watching or playing games in cellphone for more than 1 hour uninterrupted. This can become a serious problem and may even affect the eye sight early in life.

4) Irregular sleep pattern :  (surprisingly this is affecting elderly & children equally). Often elders of the house are found these days spending a lot of late night hours over watssap or Facebook.

5) Harmful effect of cell phone radiation on our brain and nervous system.

Of all the above mentioned medical issues most common are ‘neck text syndrome’  and ‘smartphone thumb’  in elderly (above the age of 65).

In children most common are aggressiveness, behavioural change, irritability, mid back pain and poor sleep pattern.

The way out of all above mentioned medical problems is through judicious use of mobile phone and self control by both elderly and adolescents.

Few steps in this direction should include –

1) Use of mobile should be restricted to maximum 20 minutes in a single stretch.

2) Maximum 1.5 hours in a day (keep alarms in cellphone to remind you and warn you). Few apps are also available which tell you about your daily mobile use.

3) Proper neck posture while talking on phone. (Try to to bring up your mobile phone to the level of your neck rather than bending the neck down)

4) Support your elbow and wrist well while working on mobile to reduce the strain over shoulder & neck muscle .

5) Type shorter texts, use abbreviations frequently.

6) Using autocorrect decreases the amount of typing to be done.

7) Use ‘Speech to text’ apps if you want to type a long message.

8)  Always use both your hands while using your phone.

9) Perform wrist and finger stretching regularly.

10) Use Bluetooth hands free while talking on phone.

11) frequent washing of eyes (specially children).

12) Meditation (specially for children)

13) Make it a rule not to use your mobile after 10 p.m. and before 8:00 a.m.

The battle against covid-19 crisis is still far from over, however if we are determined not to complicate the present situation by adding other health problems to covid-19, let’s decide that we will be using our cell phones judicially in future.