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Beware: players of pinball, Space Invaders and slot machines

By JAN ZIEGLER

BOSTON -- Doctors have identified two new ailments afflicting armchair athletes: Space Invaders wrist and slot machine tendinitis.

The afflictions may be found among those who have spent time at gambling resorts or playing video games attached to television screens, a physician and medical student suggested today in the New England Journal of Medicine.

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Timothy McCowan of the University of Arkansas College of Medicine, a video game buff, wrote he could be suffering the first identified case of Space Invaders wrist.

McCowan reported he had been troubled for a month by a stiff, painful right wrist that could not be explained by vigorous sporting activities, since he had participated in none, and was not caused by injury.

The probable cause was his frequent use of 'Space Invaders' by Atari, a popular video game that can be hooked up to home TV screens. Players use a hand-held control box with a control stick that requires a large number of rapid arm movements.

He said an investigation of the design of such games -- to minimize what may be a growing problem -- may be warranted.

'My greatest concern is that this letter will prompt a wave of reports of video-game injuries (if not a subspecialty of sports medicine). In view of the booming video-game industry, the possibilities, unfortunately, appear endless: 'Asteroids' osteoarthritis, pinball palsy, phaser felon ...'

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In another letter, Dr. Richard Neiman of the University of California-Davis and an associate, Susan Ushiroda of Lewis and Clark College at the Northwest School of Law in Portland, Ore., described an affliction 'rarely seen by physicians practicing outside of easy driving distance to gambling casinos.'

They said two patients reported excruciating right shoulder pain with no history of injury. Questioning revealed the patients had spent the previous weekend in Lake Tahoe, Nev., playing the slot machines.

They postulated symptoms may vary with how long and how hard the players hit the slot machines.

'The optimal treatment is rest or winning a jackpot early,' they wrote.

They said if the player insists on staying at the machines, a painkiller can be prescribed -- but a warning should be attached that damage may be aggravated.

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