De Quervain's Tenosynovitis, also known as De Quervain's
Syndrome or De Quervain's Disease, is a painful condition that affects the
tendons on the thumb side of the wrist. It is caused by inflammation and
irritation of the tendons and their sheaths in the first dorsal compartment of
the wrist. These tendons are responsible for moving the thumb, allowing it to
move away from the hand (abduction) and toward the palm (opposition).
The primary causes of De Quervain's Tenosynovitis
- Repetitive hand and wrist movements: Activities that involve
repetitive thumb and wrist movements, such as lifting heavy objects with the
thumb, grasping, pinching, or wringing, can strain the tendons and lead to
inflammation.
- Overuse: Engaging in repetitive activities over an extended
period without adequate rest can contribute to the development of De Quervain's
Tenosynovitis.
- Direct injury: A direct blow or impact to the thumb or wrist
can cause inflammation of the tendons.
The symptoms of De Quervain's Tenosynovitis typically
include:
- Pain: Pain is usually felt along the thumb side of the wrist
and may extend up the forearm.
- Swelling: There may be swelling and tenderness over the
thumb side of the wrist.
- Difficulty with thumb movements: Activities that involve
grasping or pinching, such as picking up objects or turning doorknobs, may
become painful and challenging.
- Crepitus: Some individuals may experience a creaking or
crackling sensation when moving the thumb.
To diagnose De Quervain's Tenosynovitis, a doctor or Hand Therapist will
typically perform a physical examination of the hand and wrist, checking for
tenderness, swelling, and pain with specific thumb movements. Finkelstein's
test is a common diagnostic test in which the Hand therapist asks the patient to make a
fist with the thumb inside the fingers and then bend the wrist towards the
little finger. This maneuver can elicit pain if De Quervain's Tenosynovitis is
present.
Treatment options for De Quervain's Tenosynovitis
- Rest and activity modification: Avoiding activities that
exacerbate the symptoms can allow the tendons to heal.
- Immobilization: Wearing a thumb splint or brace can help
rest the affected tendons and reduce inflammation.
- Kinesiotaping: Kinesiotaping provide support to the affected tendons, reduce inflammation, and alleviate symptoms such as pain and swelling. However, it's essential to combine kinesiotaping with other treatment modalities such as rest, ice therapy, splinting, and exercises Additionally, consult with a Hand therapist for proper technique and guidance on the use of kinesiotape for DQ tenosynovitis.
- Ice therapy: Applying ice to the affected area can help
reduce pain and inflammation at the initial phases of inflammation
- Heat therapy: Applying heat packs would help to reduce pain at the later phase of inflammation
- Pain management: Topical analgesia ( Deep heat, voltaren gel, dencarub etc) be recommended to alleviate pain and swelling.
- Corticosteroid injections: In some cases, corticosteroid
injections into the tendon sheath can provide significant relief from symptoms.
- Hand therapy: A custom-made thumb splint or Kinesio taping will rest the inflamed tendons, Specific exercises can help improve thumb
strength and flexibility.
- Surgery: In severe cases where conservative treatments are
not effective, a surgical procedure may be considered to release the inflamed
tendons.
If you suspect you have De Quervain's Tenosynovitis or are
experiencing symptoms, it's important to seek medical evaluation and advice for
an accurate diagnosis and appropriate treatment plan. Early intervention can
lead to a faster recovery and better outcomes.
