Case Diagnosis: Exam reveals diminished light touch sensation in the distribution of the right sciatic nerve. EMG study findings are consistent with compression neuropathy of the right sciatic nerve.
Case Description: The patient reports numbness in the lateral lower right leg with mild weakness raising his foot after playing video games in a “cross-legged” position for >6 hours without repositioning. He presents to EMG clinic for evaluation.
Discussions: Injuries resulting from playing video games have been described since 1984 (1). Injuries reported include neuropathies (1,2), tendinopathies (3,4), tendon ruptures (5), and even pain syndromes (6). The rise of movement-based gaming such as Nintendo Wii has seen an increase in MSK injuries (7,8), while more sedentary gaming appears to predispose participants to compression neuropathies (1,2), as in our case. Compression neuropathies are well described and have been seen in prolonged positioning related to occupation (9) as well as recreation. Studies have also shown a physiological decrease in the perception of pain with excessive smartphone gaming that can lead to injury (10). In addition to increasing recreational gaming, professional gaming has become a billion-dollar industry (11), making this an occupational health issue.
Conclusions: This case highlights the potential hazards of video gaming and the unique presentations it may produce. Review of the literature shows an array of injuries sustained as a sequela of gaming, including compression neuropathies, tendinopathies, and even ruptures. The rise of professional gaming elevates these health risks from recreational to occupational, making it prudent for healthcare providers to be aware of these issues and be comfortable recommending prevention strategies. This is of particular interest to physiatrists who possess the unique advantage of being experts in neurological injuries, musculoskeletal pathology, and occupational and ergonomic health.
Salman Aljilani– Physical Medicine and Rehabilitation Resident Physician, Rush University Medical Center
Andrew Patton– Resident Physician, Rush University Medical Center
Reza Tanveer– Medical Student, Chicago College of Osteopathic Medicine
Manraj Dhesi– Medical Student, Chicago Medical School
Boss Povieng– Medical Student, Loyola University Chicago Stritch School of Medicine
Theresa McCarthy– Chair of Division of PM&R, Department of Trauma, Cook County Health