De Quervain’s tenosynovitis is a common and painful disorder caused by inflammation of the protective layer of the first extensor, which surrounds the long adductor and short extensor tendons at the wrist, limiting how much you can move your wrist and the thumb.
To diagnose this disease, the physiotherapist, or an expert with a Professional Master’s Degree physiotherapy in primary care will do a Finkelstein test, in which they flex their thumb in the palm of their hand and then wrap their fingers around their thumb. Then, you must flex your wrist towards your little finger. If this causes wrist pain on the thumb side, you have de Quervain’s tenosynovitis.
Imaging tests, such as X-rays, are not usually necessary to diagnose it, so by performing the test described above, the physiotherapist is able to figure out if you suffer from this condition and will act accordingly to supply the necessary treatment.
What are the causes of de Quervain’s tenosynovitis?
Here are some points that can cause this pain disorder:
- A pre-existing health problem that causes swelling throughout the body, such as rheumatoid arthritis, a disorder that causes inflammation and pain in the joints.
- Constant tension or injury in the wrist area.
- Repeated wrist movements, some examples could be, using the computer keyboard, knitting, using a hammer, carrying heavy grocery bags, and holding a baby, among other actions.
- Practicing sports that require the handling of rackets, clubs or sticks such as tennis, skiing or rowing.
Symptoms and diagnosis
Some of the most well-known symptoms are the following:
- Pain on the side of the wrist under the base of the thumb. Moving your thumb can increase the pain.
- Mild swelling, redness, or warmth in the wrist.
- Wrist pain that has spread to the forearm and thumb.
- A fluid-filled cyst on the part of the wrist near the thumb.
What treatments exist to cure it?
Treatment for De Quervain’s tenosynovitis is intended to reduce inflammation, preserve thumb movement, and prevent recurrence of the disease. The time it takes for symptoms to improve or go away is different for each person.
If treatment is prioritized early, symptoms should ease within four to six weeks. But if it starts during pregnancy, symptoms may stop around the end of pregnancy or breastfeeding. According to it, there are various kinds of treatment, it depends on the duration and severity of symptoms and the therapist will decide which one is the best choice for you.
- Treatments to prevent further pain and swelling:
- Avoid performing repetitive movements, pinching your fingers while moving your wrist, or actions that can cause pain.
- In addition, the use of a wrist and thumb brace can be implemented to keep the thumb and wrist in a neutral position, without bending up or down, so as not to cause tension.
- You can also see a physiotherapist or an occupational therapist. They will be able to evaluate the way you use your wrists and suggest how to adjust and ease the strain. As well they can teach you exercises for your wrists, hands, and arms to strengthen your muscles, reduce pain, and limit tendon irritation.
- Anti-inflammatory modalities such as interferential current therapy can also be used by physiotherapists to help treat De Quervain’s tenosynovitis.
- Acupuncture can also help by using either the dry needle technique or percutaneous electrolysis to relieve pain. This treatment uses electrical current in acupuncture needles applied to the involved area to repair damaged tissue and tendons.
- Another method that helps is to put ice or heat on the wrist, depending on the case, the physiotherapist will tell you which one you should use.
- Treatments to relieve pain and swelling: To reduce pain and swelling, your doctor may recommend over-the-counter pain relievers such as ibuprofen (Advil, Motrin), Naproxen (Aleve), Celecoxib (Celebrex), Meloxicam (Mobic), and Diclofenac (Voltaren). Also, corticosteroid injections are used if the pain does not go away after trying other treatments, it can help reduce pain and swelling for weeks or months.
- Surgery: If your case is more severe, the doctor may recommend outpatient surgery, which involves a procedure that inspects the sheath that surrounds the affected tendons and then opens it to release pressure and allow the tendons to glide freely.
Once finished, they will refer you to physiotherapy for your rehabilitation. Then, an expert will aid you with new strengthening exercises and help you adapt your daily routine to avoid future problems.
In conclusion, the main goal of physiotherapy is to reduce or end the cause of thumb tendon irritation by following the proper treatment and if you have this pain disorder, you should consult a specialist to guide you in the healing process. The AMS Clinic offers free consultations in-person, over tele-medicine or by phone.
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