# Video game–related health problems

Game addiction problems can induce repetitive strain injuries, skin disorders or other health issues. Other problems include video game-provoked seizures in patients with epilepsy. In rare and extreme cases, deaths have resulted from excessive video game playing (see Deaths due to video game addiction).

## General findings

Since their inception, video games have been the subject of concern due to the depictions of violence they may contain, which have heightened as the technology behind video games improve the amount of visual detail and realism of games. Video games are often seen as a possible cause to violent actions, notably in the aftermath of the 1999 Columbine High School massacre, but academic studies have yet to identify any direct evidence between depictions of violence in video games and violent behavior.
According to a 2019 Sutter Health article, in "24 studies involving 17,000 children...", there was in fact a near-direct correlation between violent games and violent behavior. However, there are also reported upsides to gaming, such as an increased hand-eye coordination, and decision-making.
There may or may not be an accompanying video game addiction. Video games are also been linked in some studies to aggressive behavior and violence or fearful behavior by its players in the short term, although other studies have not supported this link.
Studies have mainly reported health problems in children, mainly boys. Several specific names have been given to video-game related health problems, for example PlayStation thumb, Nintendinitis and acute Wiiitis; however, the literature does not seem to support these as truly separate disease entities. Video game consoles linked to medical problems include the PlayStation and the Nintendo Wii, although it is unknown whether certain types are more connected to these problems than others. Physical signs linked to excessive video game playing include black rings in the skin under the eyes and muscular stiffness in the shoulders, possibly caused by a tense posture or sleep deprivation.
Existing literature on gaming is inconsistent, and studies occasionally produce contradictory results. Some studies show strong correlations between gaming and psychological issues, such as increased aggression in males and increased depression in females. Another study claims that girls who gamed were less likely to experience depression, but were more likely to get into fights.
In 2009, during a speech to the American Medical Association, US President Barack Obama identified video games as a health concern, stating that they are a key factor in unhealthy sedentary lifestyles.

## Musculoskeletal issues

When questioned, children often admit to having physical complaints during too much video game playing, for example pain in the hands and wrists, back and neck. Ergonomic measures could improve postural problems associated with video game playing.
A 2004 case report in The Lancet, authored by a 9-year-old boy, mentions the Playstation thumb, which features numbness and a blister caused by friction between the thumb and the controller from rapid game play. Using dermoscopy, dermatologists found point-like hemorrhages and onycholysis (letting go of the nail) in a patient who presented with hyperkeratosis.
Nintendonitis has been used to describe tendon injuries (tendinosis) of the hands and wrists in Nintendo players.
A 2010 case report in the New England Journal of Medicine reported a fracture of the base of the fifth metatarsal after using a Wii balanceboard; this was dubbed a Wii fracture.
A further study involving musculoskeletal symptoms and computer use among Finnish adolescents affirmed the association between musculoskeletal symptoms and computer usage. The study claims that daily computer use of 2 hours or more increases the risk for pain at most anatomic sites.
Consistently long sessions of video game play also leads to an increased likelihood of lower back pain, according to a study conducted in a population of school children. Children who played video games for more than 2 hours a day were more inclined to have lower back pain; however, the same could not be said for those who watched television instead.

## Vision problems

Too much video game playing may cause vision problems. Extensive viewing of the screen can cause eye strain, as the cornea, pupil, and iris are not intended for mass viewing sessions of electronic devices. Using video games for too long may also cause headaches, dizziness, and chances of vomiting from focusing on a screen. However, playing video games can also help eyesight because it increases reaction speeds and thought times.
Certain studies have shown that video games can be used to improve various eye conditions. An investigation into the effect of action gaming on spatial distribution of attention was conducted and revealed that gamers exhibited an enhancement with attention resources compared to non-gamers, not only in the periphery but also in central vision. Further studies in 2011 concluded that a combination of video game therapy alongside occlusion therapy, would greatly improve the recovery of visual acuity in those experiencing amblyopia.

## Epileptic seizures

Concerns that video games can trigger epileptic seizures began in the early 1980s, with the first medically documented case of a video game-induced seizure occurring in 1981. In early 1993, The Sun reported a boy choked to death on his own vomit during a seizure triggered by playing a video game; similar though less serious incidents were subsequently reported by news media around the world, and within a year all video game console manufacturers required that epilepsy warnings be included in the instruction manuals for all games published for their consoles.
Studies published in 1994 in Pediatrics and The Lancet found that video games only cause seizures in people already predisposed to epilepsy, and that people with a predisposition to epilepsy can greatly reduce the risk of a seizure by staying 10 feet or more away from the TV set and wearing sunglasses while playing.

## Obesity

Video game play is frequently associated with obesity. Many studies have been conducted on the link between television & video games and increased BMI (Body Mass Index). Due to video games replacing physical activities, there appears to be a clear association between time spent playing video games and increased BMI in young children. One such study produced data that indicated that boys who spend less than 1.5 hours on the television and playing video games, were 75.4% less likely to be overweight than those who spend more than 1.5 hours.
A study conducted in 2011 formalized the association of video game play and an increase in food intake in teens. A single session of video game play resulted in an increase in food intake, regardless of appetite. The recent trend of "active video games" revolving around the Wii and Xbox Kinect might be a way to help combat the aforementioned problem, however, this finding still needs confirmation from other studies. Furthermore, a study conducted in Baylor College of Medicine revolving around children claims that there is no evidence which supports the belief that acquiring an active video game under naturalistic circumstance would result in a beneficial outcome toward children. The study produced no results showing an increased amount of physical activity within the children receiving the active video games. It has been estimated that children in the United States are spending 25 percent of their waking hours watching television and playing video games. Statistically, the children who watch the most hours of television or play video games are shown to have the highest incidence of obesity.

## Footnotes

* ↑ Shoja MM, Tubbs RS, Malekian A, Jafari Rouhi AH, Barzgar M, Oakes WJ (March 2007). "Video game epilepsy in the twentieth century: a review". Childs Nerv Syst. 23 (3): 265–7. doi:10.1007/s00381-006-0285-2. PMID 17211654. S2CID 12036884.
* ↑ Lawley, claire M.; et al. (10 October 2022). "Life-threatening cardiac arrhythmia and sudden death during electronic gaming: An international case series and systematic review". Heart Rhythm. 19 (11): 1826–1833. doi:10.1016/j.hrthm.2022.08.003. PMID 37850595. S2CID 252862267. Retrieved 11 October 2022.
* ↑ Video game controversies#Violence
* ↑ "The Impact of Video Games | Sutter Health". www.sutterhealth.org. Retrieved 2024-02-11.
* ↑ Lopez-Fernandez, Olatz, ed. (2019). Internet and mobile phone addiction: health and educational effects. Environmental research and public health. Special issue. Basel, Switzerland: MDPI. ISBN 978-3-03897-605-9.
* ↑ Huesmann LR, Taylor LD (2006). "The role of media violence in violent behavior". Annu Rev Public Health. 27 (1): 393–415. doi:10.1146/annurev.publhealth.26.021304.144640. PMID 16533123.
* ↑ Ferguson CJ, Kilburn J (May 2009). "The public health risks of media violence: a meta-analytic review". J. Pediatr. 154 (5): 759–63. doi:10.1016/j.jpeds.2008.11.033. PMID 19230901.
* ↑ Browne KD, Hamilton-Giachritsis C (2005). "The influence of violent media on children and adolescents:a public-health approach" (PDF). The Lancet. 365 (9460): 702–10. doi:10.1016/S0140-6736(05)17952-5. PMID 15721477. S2CID 918943.
* ↑ Ellwood, Beth (2021-11-30). "Longitudinal study finds no evidence that violent video games lead to aggression". PsyPost. Retrieved 2023-10-06.
* ↑ Rodríguez, Mónica Rodríguez; Padilla, Francisca María García (2021-04-01). "El uso de videojuegos en adolescentes. Un problema de Salud Pública". Enfermería Global (in Spanish). 20 (2): 557–591. doi:10.6018/eglobal.438641. hdl:10272/19728. ISSN 1695-6141.
* 1 2 Gillespie RM (2002). "The physical impact of computers and electronic game use on children and adolescents, a review of current literature". Work. 18 (3): 249–59. PMID 12441565.
* ↑ Bonis J (June 2007). "Acute Wiiitis". N. Engl. J. Med. 356 (23): 2431–2. doi:10.1056/NEJMc070670. PMID 17554133.
* ↑ Tazawa Y, Okada K (December 2001). "Physical signs associated with excessive television-game playing and sleep deprivation". Pediatr Int. 43 (6): 647–50. doi:10.1046/j.1442-200X.2001.01466.x. PMID 11737743. S2CID 46172116.
* ↑ Weaver JB III, Mays D, Sargent Weaver S, Kannenberg W, Hopkins GL, Eroğlu D, Bernhardt JM (October 2009). "Health-risk correlates of video-game playing among adults". Am J Prev Med. 37 (4): 299–305. doi:10.1016/j.amepre.2009.06.014. PMID 19765501.
* ↑ Desai RA, Krishnan-Sarin S, Cavallo D, Potenza MN (December 2010). "Video-gaming among high school students: health correlates, gender differences, and problematic gaming". Pediatrics. 126 (6): 1414–24. doi:10.1542/peds.2009-2706. PMC 3678538. PMID 21078729.
* ↑ "Obama Names Video Games as Health Concern in Speech to A.M.A." GamePolitics.com. 15 June 2009.
* ↑ Burke A, Peper E (2002). "Cumulative trauma disorder risk for children using computer products: results of a pilot investigation with a student convenience sample". Public Health Rep. 117 (4): 350–7. doi:10.1093/phr/117.4.350. JSTOR 4598761. PMC 1497444. PMID 12477916.
* 1 2 Ramos EM, James CA, Bear-Lehman J (2005). "Children's computer usage: are they at risk of developing repetitive strain injury?". Work. 25 (2): 143–54. PMID 16131744.
* ↑ Zapata AL, Moraes AJ, Leone C, Doria-Filho U, Silva CA (June 2006). "Pain and musculoskeletal pain syndromes related to computer and video game use in adolescents". Eur. J. Pediatr. 165 (6): 408–14. doi:10.1007/s00431-005-0018-7. PMID 16552547. S2CID 25399018.
* ↑ Vaidya HJ (March 2004). "Playstation thumb". Lancet. 363 (9414): 1080. doi:10.1016/S0140-6736(04)15865-0. PMID 15051306. S2CID 26563611.
* ↑ Karim SA (June 2005). "Playstation thumb--a new epidemic in children" (PDF). S. Afr. Med. J. 95 (6): 412. PMID 16100887.
* ↑ Bakos RM, Bakos L (December 2006). "Use of dermoscopy to visualize punctate hemorrhages and onycholysis in "playstation thumb"". Arch Dermatol. 142 (12): 1664–5. doi:10.1001/archderm.142.12.1664. PMID 17179012.
* ↑ Macgregor DM (October 2000). "Nintendonitis? A case report of repetitive strain injury in a child as a result of playing computer games". Scott Med J. 45 (5): 150. doi:10.1177/003693300004500507. PMID 11130299. S2CID 25033136.
* ↑ Eley KA (2010). "A Wii Fracture". N Engl J Med. 362 (5): 473–474. doi:10.1056/nejmc0909544. PMID 20130262.
* ↑ Hakala PT, Saarni LA, Punamäki RL, Wallenius MA, Nygård CH, Rimpelä AH (March 2012). "Musculoskeletal symptoms and computer use among Finnish adolescents--pain intensity and inconvenience to everyday life: a cross-sectional study". BMC Musculoskelet Disord. 13 (41): 41. doi:10.1186/1471-2474-13-41. PMC 3348031. PMID 22439805.
* ↑ Gunzburg R, Balagué F, Nordin M, Szpalski M, Duyck D, Bull D, Mélot C (1999). "Low back pain in a population of school children". Eur Spine J. 8 (6): 439–43. doi:10.1007/s005860050202. PMC 3611220. PMID 10664300.
* ↑ Green CS, Bravelier D (December 2006). "Effect of action video games on the spatial distribution of visuospatial attention". J Exp Psychol Hum Percept Perform. 32 (6): 1465–78. doi:10.1037/0096-1523.32.6.1465. PMC 2896828. PMID 17154785.
* ↑ Li RW, Ngo C, Nguyen J, Levi DM (August 2011). "Video-game play induces plasticity in the visual system of adults with amblyopia". PLOS Biol. 9 (8): e1001135. doi:10.1371/journal.pbio.1001135. PMC 3166159. PMID 21912514.
* 1 2 3 "Do Video Games Screw You Up?". Next Generation (10). Imagine Media: 38. October 1995.
* ↑ Carvalhal MM, Padez MC, Moreira PA, Rosado VM (June 2006). "Overweight and obesity related to activities in Portuguese children, 7-9 years". Eur J Public Health. 17 (1): 42–6. doi:10.1093/eurpub/ckl093. PMID 16793838.
* ↑ Rehbein F, Kleimann M, Mössle T (June 2010). "Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey". Cyberpsychol Behav Soc Netw. 13 (3): 269–77. doi:10.1089/cyber.2009.0227. PMID 20557246.
* ↑ Chaput JP, Visby T, Nyby S, Klingenberg L, Gregersen NT, Tremblay A, Astrup A, Sjödin A (June 2011). "Video game playing increases food intake in adolescents: a randomized crossover study". Am J Clin Nutr. 93 (6): 1196–203. doi:10.3945/ajcn.110.008680. PMID 21490141.
* ↑ Maddison R, Foley L, Ni Mhurchu C, Jiang Y, Jull A, Prapavessis H, Hohepa M, Rodgers A (July 2011). "Effects of active video games on body composition: a randomized controlled trial". Am J Clin Nutr. 94 (1): 156–63. doi:10.3945/ajcn.110.009142. hdl:10536/DRO/DU:30081953. PMID 21562081.
* ↑ Biddiss E, Irwin J (July 2010). "Active video games to promote physical activity in children and youth: a systematic review". Arch Pediatr Adolesc Med. 164 (7): 664–72. doi:10.1001/archpediatrics.2010.104. PMID 20603468.
* ↑ Baranowski T, Abdelsamad D, Baranowski J, O'Connor TM, Thompson D, Barnett A, Cerin E, Chen TA (March 2012). "Impact of an active video game on healthy children's physical activity". Pediatrics. 129 (3): 636–42. doi:10.1542/peds.2011-2050. PMC 3289528. PMID 22371457.
* ↑ Dillard, Lauren K.; Mulas, Peter; Der, Carolina; Fu, Xinxing; Chadha, Shelly (2024). "Risk of sound-induced hearing loss from exposure to video gaming or esports: a systematic scoping review". BMJ Public Health. 2 (1). BMJ: e000253. doi:10.1136/bmjph-2023-000253.