Prevalence of Text Thumb Syndrome Amongst Students of Sargodha Medical College and Its Association With Quality of Life in Wrist

Abstract

Background: De Quervain’s tenosynovitis (DQT) is an inflammatory tendon-sheath disorder affecting the abductor pollicis longus and extensor pollicis brevis tendons, frequently linked to repetitive thumb motion during smartphone use. The widespread adoption of mobile devices has increased the incidence of thumb and wrist overuse injuries, yet region-specific data quantifying prevalence and functional consequences remain limited among South Asian student populations. Objective: To determine the prevalence of DQT among students at Sargodha Medical College and to evaluate its association with wrist-related quality of life, while identifying behavioral and ergonomic risk factors related to smartphone use. Methods: A cross-sectional observational study was conducted from January to March 2025 among 205 students aged 17–26 years who used smartphones for at least two hours daily. Data were collected using a structured questionnaire, the Finkelstein test for DQT diagnosis, the Universal Pain Assessment Tool (UPAT) for pain grading, and the Patient-Rated Wrist Evaluation (PRWE) for functional assessment. Descriptive statistics, chi-square tests, and multivariate logistic regression were applied using SPSS version 25. Results: Of 205 participants, 111 (54.1%) tested positive on the Finkelstein test. Right-hand involvement was predominant (76.6%), and pain severity was strongly associated with test positivity (p<0.001). Combined texting and gaming doubled the odds of DQT (adjusted OR 2.07, 95% CI 1.05–4.08), while typing speeds above 40 words per minute increased odds nearly threefold (adjusted OR 2.67, 95% CI 1.01–7.07). Finkelstein-positive participants had higher mean PRWE scores (18.6 ± 7.3) compared to negatives (11.5 ± 6.4; p<0.001). Conclusion: Over half of medical students exhibited DQT symptoms linked to high-frequency smartphone use, particularly when engaging in rapid or dual-purpose activities. The strong relationship between pain severity, Finkelstein positivity, and PRWE scores underscores the functional burden of this emerging repetitive strain injury. Preventive ergonomic strategies and early interventions are warranted to reduce the risk of chronic wrist dysfunction among young smartphone users.