Not everything that happens in Vegas stays in Vegas.

Take slot-machine tendinitis, for example — a rare but real condition that Dr. Bernard Portner, a Honolulu medical orthopedist, treats several times a year.

"It’s not a common condition that I see, but I see people that get so zoned out, you just get hypnotized by a video game or by a slot machine," he said. "People sit there in a trance — a one-arm bandit — and they develop overuse syndrome, or tendinitis, some sort of wearing out of a structure just from being used over and over."

Orthopedic surgeon Jeffery Kimo Harpstrite, vice president of the Hawaii Orthopaedic Association, said as technology has changed, so have the symptoms.

Now that there are fewer slot machines in Las Vegas, injuries such as tennis elbow from pulling slots are turning into wrist and finger tendinitis because of the use of electronic buttons.

"Like all good local people, (my patients) have got to go to Vegas," he said. "Nowadays they tell me, ‘Don’t worry, we only push buttons.’"

While the slot-machine condition is rare, the scenario has become more prevalent in an increasingly connected society where texting, Web browsing, gaming and social networking on hand-held devices and computers are a part of the virtual lifestyle.

Overuse injuries include such conditions as tendinitis, sprains, strains and even arthritis, with many people not immediately feeling the pain because they’re so engrossed in what they’re doing, Portner said. Symptoms can range from pain in the hands and wrists to blisters and callouses on fingers.

"We’re getting arthritis thumbs in young people just because they do so much gaming," added Portner, who treats these types of overuse injuries at least once a month. "That’s going to probably be major injuries in the future."

Kaimuki resident David Miller, a self-proclaimed video game addict, began experiencing severe pain in his hands after spending as much as 12 hours a day playing video games to pass the time.

Miller, 37, had been laid off from his managerial position a year ago and turned to his Xbox to relieve boredom.

"When I first started playing I would play all day. I felt like I worked out. My hands and my thumbs were all fat from pushing the buttons," he said. "I would wrap my fingers up with paper towels or rags. For three weeks straight I had sore hands from playing Xbox. It was to the point I couldn’t move."

Overuse injuries used to commonly occur in the work force with manual laborers, but today the condition is more from recreational and computer use, according to Stephen Scheper, a physical rehabilitation specialist who works with Portner.

It’s not just a problem for young adults and teenagers. It "has started to transcend the generation," Scheper said.

"Older people are getting much more computer savvy; people may have a little more time on their hands and are spending it on electronic devices," he said of patients in their 60s and 70s who have become more familiar with computers.

"It’s surprising when you see someone who you wouldn’t expect would be hurting themselves using a cell phone, and they often have no clue that’s how it came about," Scheper said. "Within the past generation, our thumbs have become the most dexterous digit of our hands — where it used to be our index fingers."