Smartphone use and related factors with hand pain among university students: a systematic review

University students often use smartphones for daily tasks, which can lead to awkward posture and musculoskeletal pain in the hand, wrist, and fingers due to prolonged use. This review aims to investigate the relationship between smartphone use and hand pain among university students.

For this review, we collected and analyzed original English-language articles published between 2014 and 2024. Keywords were selected from the MeSH database. We excluded review articles, books, letters, reports, and other non-original sources, as well as studies that focused on mobile phones or populations other than university students and smartphone users. Additionally, articles addressing pain in other body parts, injuries, and complications from smartphone use, as well as those published during the COVID-19 pandemic, were also omitted. We utilized various keyword combinations related to "university", "students", "smartphone use", "addiction", "overuse", "hand", "pain", "musculoskeletal pain", "wrist", "fingers", "thumb", "risk factors", "characteristics", and "posture" in the search, along with the use of "AND", "OR", or no conjunctions, and the use of quotation marks for one, two, or a few keywords. Literature was obtained from databases such as Web of Science, ScienceDirect, Scopus, PubMed, and ProQuest. A total of 18 studies were selected from 390 primary literature sources, following the PRISMA framework.

A total of 393 articles were found in the initial search. Duplicate articles were removed, leaving 259 that were examined according to inclusion and exclusion criteria. After assessing the relevance of titles and abstracts, screening, and qualitatively evaluating journals, 18 articles were included in the study. Brazil, Saudi Arabia, and Turkey had the highest number of articles (n = 3 or 16.6% of articles). The age group investigated was 18 to 26 years old. Based on the identified risk factors, the articles were discussed in three groups: (1) role of smartphone duration, addiction, and hand pain (83.3% of studies investigated the duration of smartphone use, while 38.8% surveyed smartphone addiction), (2) the effect of smartphone holding posture on the hand and hand pain (38.8% of studies), and (3) the relation of smartphone physical characteristics to hand pain (27.7% of studies). Daily usage duration ranged from less than or equal to 4 h/day (53.2%) to 7 h or more (73.9%). The reported range of smartphone addiction among students was between 15.9% and 66.6%. The reported prevalence of wrist, hand, and thumb pain was 19.2% to 68.7%. Between 14.75% and 41% of students use their right hand to hold smartphones and type with their right thumb, while 24% to 77.79% use both hands and both thumbs. The size and weight of smartphones can predict hand pain.

The amount of time spent using a smartphone, how it is held, how long it has been owned, smartphone addiction, holding posture, frequent thumb movements, preferred hand position, screen size, weight of the smartphone, and smartphone -related the purpose of usage are all risk factors that can lead to pain in the hand, wrist, palm, thumb, and other fingers.