What is De Quervain's tenosynovitis?
De Quervain's Tenosynovitis an inflammatory condition of the tendons that extend across the wrist below the thumb. It is a fairly common repetitive strain injury that causes pain when the individual resists ulnar deviation of the wrist. This typically occurs when lifting heavy objects, supporting the weight through the wrist, with the thumb upmost. It is commonly seen in people whom care for children, as a result of repeatedly lifting the child up. Although any repetitive lifting action can cause the same effect. The two tendons affected are the extensor pollicis brevis and the abductor pollicis longus.
What causes De Quervain's tenosynovitis?
De Quervain's Tenosynovitis is the result of micro tears to the extensor pollicis brevis and abductor pollicis longus tendons. As these micro tears heal they can cause the tendons to thicken, which can lead to irritation of the tendons and the sheaths that surround them as they move.
It is through sudden heavy lifting or repetitive over use that damage, in the form of micro tears, begins in the wrist tendons. Such damage is more likely to occur when there is a sudden increase in new activity, or if there is jarring actions putting intense pressure through the wrists.
Activities that may lead to developing De Quervain's Tenosynovitis include the repeated lifting of babies and small children, gardening, playing an instrument and generally any repetitive lifting.
Above: De-quervains symptoms can make everyday activities extremely uncomfortable if left untreated.What are symptoms of De Quervain's tenosynovitis?
If you have developed De Quervain's Tenosynovitis you may experience some of the following symptoms;
- Pain, usually localised to the base of the thumb, aggravated by pinching or gripping actions.
- Swelling around the wrist at the base of the thumb.
- Redness over the affected tendons.
- Tenderness in the soft tissues over the tendons, at the base of the thumb.
- Stiffness or a catch and release sensation when moving the thumb.
- Referred pain may eventually spread throughout the thumb wrist and forearm.
How is De Quervain's Tenosynovitis diagnosed?
De Quervain's Tenosynovitis is usually diagnosed based on its common presentation as described in the symptoms above. Its presence can be further confirmed by use of the Finkelstein Test, which consists of flexing the thumb across the palm then passive ulnar deviation at the wrist. If the test is positive then pain is experienced in the wrist at the base of the thumb.
If you suspect you have De Quervain's Tenosynovitis you would benefit from an assessment from one of our experienced physiotherapists. For more information or to book an appointment, please email office@liverpoolphysio.co.uk or call 0151 558 0077.
What would Physiotherapy treatment for De Quervain's Tenosynovitis involve?
Physiotherapy treatment for De Quervain's Tenosynovitis will involve reducing the painful symptoms and modifying patterns of activity to avoid aggravating factors during the recovery. This will include postural correction of the hand and wrist during activity to reduce loading on the painful tendon. Physiotherapy treatment at Liverpool Physio may include:
- Task avoidance and modification to reduce aggravation during recovery.
- Use of heat therapies, including ice, to reduce pain and swelling.
- Use of ultrasound to promote soft tissue healing.
- Advice on the use of forearm or thumb splints during the night.
- Stretching exercises to maintain flexibility and range of movement.
- Progressive strengthening exercises to maintain functional ability, joint stability and reduce risk of re-injury.
- Dexterity exercises to regain and maintain fine motor skills.
- Work station assessments to reduce risk of repetitive strain during work.
Above: A patient being treated for De Quervains.For more information about physiotherapy for De Quervain's Tenosynovitis, or to book an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I.
How can I arrange a physiotherapy assessment for De Quervain's Tenosynovitis?
If you are experiencing localised pain in your wrist just below the base of your thumb, that is aggravated when you stretch that part of your wrist you may have De Quervain's Tenosynovitis.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I.
Summary
De Quervain's Tenosynovitis can be very painful and have a significant negative impact on your activities of daily living or sports participation. This results from the pain being aggravated by the most basic lifting action of the hand and wrist.
The treatments for De Quervain's Tenosynovitis are very effective and you can expect a full recovery, with advice on how to minimise the risk of re-occurrence. Our experienced physiotherapists will relieve painful symptoms and work with you to regain normal function. Progressive stretching and strengthening exercises will help you maintain normal function and avoid future re-injury.
For more information about physiotherapy for De Quervain's Tenosynovitis, or to book an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I.
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