Tennis players risk tennis elbow. Computer geeks get mouse wrist. Steve Maviglio, a preternaturally connected Sacramento political consultant, developed BlackBerry thumb.
A former press secretary for Gov. Gray Davis, Maviglio suffered a painful repetitive stress injury aggravated by compulsive use of the portable e-mail device that's become an unlikely icon of status and chic.
Some hand experts worry that what's now a boutique affliction among the gabbier circles of entertainment, marketing and politics will become more common as Americans tether themselves to increasingly diminutive and addictive electronic gadgetry.
The American Society of Hand Therapists, for instance, warns of possible injuries from improper or excessive use of hand-held electronic devices -- particularly the BlackBerry, iPod and text-messaging phone, all of which rely heavily on thumbs to type or navigate menus.
"We're not seeing a whole lot of it yet, but we're concerned that we're going to be seeing a lot more of it in the next three to five years," said therapist Stacey Doyon of Portland, Maine. "Our lifestyles are so fast-paced and stressful now that people are using more of these gadgets constantly, and that's where the problem starts."
The problem described by Doyon affects only a small fraction of the most devoted of BlackBerry's 3.5 million users -- and the 2 million users of Palm Inc.'s rival Treo. Most don't send nearly as many messages as Maviglio, who receives and sends hundreds a day.
Maviglio first got his hands on a BlackBerry -- dubbed CrackBerry by habitual users -- during the California energy crisis and quickly became enamored of the ability to send lightning-fast text messages to his fellow political operatives. But Maviglio developed shooting pains in his hands.
An ergonomics specialist suspected his malady was a direct consequence of the way he was holding his BlackBerry, made by Research in Motion Ltd.
"I noticed sharp pain in the area between my thumb and index finger," said Maviglio, who now spends his days criticizing Gov. Arnold Schwarzenegger and whose friends have suggested that he dress up as a BlackBerry for Halloween. "I remember making more telephone calls deliberately to avoid having to use the keyboard and the BlackBerry."
Hand surgeons acknowledge that the repetition of pecking at tiny keys can exacerbate existing conditions, but few believe that the gadgets cause the problem.
"It cannot happen," said Dr. Robert Szabo of Sacramento. "If anybody has any symptoms, it's because they have underlying problems."
Szabo, a member of the American Society for Surgery of the Hand, said the three most common thumb disorders were arthritis around the base of the thumb, tendinitis at the base and De Quervain's tenosynovitis, which involves the tendons between hand and thumb.
"If you hold anything like a cellphone or grab anything like a steering wheel, that can aggravate those pains," Szabo said. "If someone with lower back pain sits in a plush low sofa and has trouble getting up, the sofa didn't cause his problem. He may have had bad posture to begin with and that triggered the underlying disease."
Rest and therapy solve most conditions caused by repetitive stress -- whether it's tapping on a BlackBerry, typing on a computer or using a video game controller.
"You have to control the frequency and duration of use," said Dr. Keith Raskin, an orthopedic surgeon at New York University Medical Center. "You have to say, 'I can't use a BlackBerry for seven hours every day.' You use it for a few hours and rest."
Or go without.
"I just can't do that," said Lee Caraher, president of Double Forte, a marketing and communications firm in San Francisco.
She receives as many as 450 e-mails a day and experiences "a growing ache" in her hands from using the device as her day wears on. Caraher said she fired off longer e-mails in the morning when her fingers were fresh, but by the end of the day her messages were reduced to responses like "on bb email later" because her hands hurt.
"For me, the pain is the cramping," Caraher said. "If you were to take your hand and make a claw, that's how it feels."
A busy mother of two who is active with her church, Caraher said giving up her BlackBerry was simply not an option given the many hours she spent commuting between her office in San Francisco and her home on the Peninsula. Instead, she relieves the pain by putting her BlackBerry down and shaking out her hands.
Maviglio, now a consultant for the labor group Alliance for a Better California, said the ergonomics expert he consulted told him he was using his BlackBerry incorrectly by relying on his thumbs to type messages.
"It's almost like you're praying," Maviglio said. "Your hands are closely cropped together with one hand on each side of the BlackBerry. Your thumbs do all the walking and that is basically the wrong way to do it."