What is DeQuervain’s Tenosynovitis?
DeQuervain’s tenosynovitis is inflammation involving 2 of the tendons in the thumb and along the side of the wrist. The names of these 2 muscles are the extensor pollicis brevis and the extensor pollicis longus, as depicted above. First, to break down the naming, the Latin name of the thumb is pollex, hence pollicis, while the “extensor” refers to the movement that the muscles create at the thumb, extension! Lastly, brevis and longus refers to how short (or brief!) or long the muscle is with brevis being the shorter and longus the longer. In tenosynovitis, these 2 muscles thicken and swell above their normal side. As a result, the tendons don’t slide as easily and normal mobility of the hand, wrist and thumb become painful.
Who gets DeQuervain’s Tenosynovitis?
Usually, this is a repetitive sprain injury so individuals that use their hand and wrists a lot in their daily life or workplace are more susceptible to developing DeQuervain’s. Oftentimes, it is developed in middle aged individuals around 30-50 years old. For example:
- Women during or after a pregnancy
- Parents with small children or baby care
- Job or hobbies that include repetitive grasping or holding
What are the signs and symptoms?
Symptoms will vary based on the severity of the injury and may feel different for each individual. Most commonly, people with DeQuervain’s report:
- Pain at the wrist and thumb
- Swelling at the thumb and over the wrist
- Locking, catching, or sticky sensation when moving the thumb
- Difficulty and pain with thumb and wrist movements, especially twisting, grabbing, and lifting
- If more severe, pain may go up the forearm as well
How is it diagnosed?
A health care professional should examine your hand to determine whether there is DeQuervain’s. First, they will look at your thumb and wrist on the affected side and check for pain, swelling, and impairments in your mobility. Next, a specific test, named the Finkelstein’s test may be used to check for the possibility of DeQuervain’s. Your health care professional will put your thumb into your palm and have you make a fist around it, then bend your wrist towards the pinky side of your hand. Then, a test is considered positive if it recreates your pain at the thumb/wrist and indicates that you may have DeQuervain’s. Additionally, medical imaging like an Ultrasound can show DeQuervain’s.
How is DeQuervain’s Tenosynovitis treated?
Physiotherapy Treatment is an effective way to manage and resolve your thumb pain. In the early stages, DeQuervain’s management involves relative rest, bracing or splinting, in order to let the tendon heal and inflammation resolve. A lot of this will involve proper education on when to wear the brace, activities you should avoid or modify, and how to manage your symptoms effectively.
Once you attend Physiotherapy, they may use treatments such as
- Manual therapy and massage techniques to help with pain and stiffness
- Laser and Ultrasound to help with pain and inflammation
- Electrotherapy for pain relief
- Custom exercise programs to improve your mobility, strength, and prevent a reoccurring issue
- Grip retraining
Most cases of DeQuervain’s resolve conservatively with Physiotherapy Treatment. Unfortunately, in some cases, the pain becomes chronic and a referral to surgery may be indicated. Next, in this surgery, the tendon sheath is cut to make more room for the irritated tendons, which effectively resolves the symptoms. Additionally, recovery from this surgery is fairly simple and few encounter post-surgical complications.
Where can I find treatment?
If you are experiencing DeQuervain’s or any other kind of hand pain, look for PhysioNow! We are a Physiotherapist owned and operated clinic with locations across the GTA. Specifically from Burlington, Oakville, Mississauga, and Etobicoke we have 10 locations to offer our patient’s convenience. Book with us today for your first assessment and treatment with a Physiotherapist!
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