Disclaimer: Please be aware that information in this article is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of a qualified health provider prior to starting any new treatment or with any questions you may have regarding an injury or medical condition.
Written by: Taylor Post BA-Kin, CAT(C)
While few are able to pronounce its name, De Quervain’s tenosynovitis is one of the most common injuries to the wrist and hand. De Quervain’s tenosynovitis refers to the inflammation of the tendons that control movement of the thumb. These tendons, called abductor pollicis longus (APL) and extensor pollicis brevis (EPB) are encased in a tendon sheath, which acts like a membranous covering. Repeated movement can cause the tendon sheath to become inflamed and thickened. This leads to pain and often swelling located at the base of the thumb.
What causes De Quervain’s tenosynovitis?
Overuse or repetitive movements of the thumb and wrist are usually the root cause of De Quervain’s tenosynovitis. One of the most common cases of De Quervain’s is in new mothers, due to the repetitive movements associated with lifting, carrying and nursing their baby. So much so, that this injury has also been nicknamed “mommy thumb”. The hormonal changes associated with pregnancy also put women at increased risk. Jobs or hobbies that involve repetitive hand and wrist motions (golf, typing, playing a musical instrument, carpentry etc.) may also lead to De Quervain's tenosynovitis.
What are the symptoms?
This injury can present differently depending on the individual, but it often includes the following complaints:
• Pain at the base of the thumb and or wrist.
• Swelling and inflammation.
• Creaking or “sticking” sensation when moving the thumb.
• Poor grip strength or difficulty gripping and grasping.
What are the treatment options for De Quervain’s tenosynovitis?
• Treatment of De Quervain’s often involves resting or immobilizing the affected hand. This could include wearing a brace and stopping or modifying the way you perform the tasks that lead to the injury.
• Ice can help with the initial pain of this injury. Use crushed ice if possible; and leave it on for 20 minutes every hour.
• If you’re experiencing more stiffness than pain, try applying moist heat to the hand for 20-minute intervals.
• NSAIDS (non steroidal anti-inflammatory drugs) such as ibuprofen and naproxen can help to manage pain and inflammation.
• Exercises and stretches to maintain mobility and regain strength (see part two of this article!).
• Cortisone injections can also be used to treat the inflammation, and in very rare cases, surgical intervention may be required.
What is the prognosis with De Quervain's tenosynovitis?
The prognosis of this injury is usually very good. It is essential to give your wrist and thumb an opportunity to heal with rest, and the use of a thumb brace or spica. You may also need to make modifications to the way you do certain activities to avoid re-aggravating your injury. Once the pain and inflammation is under control, stretching and strength exercises can help you regain normal function. With non-surgical intervention, you should see an improvement in 4 to six weeks.
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