De Quervain's Tenosynovitis | Plenty Physiotherapy, Bundoora

De Quervain's Tenosynovitis Document

DeQuervain’s tenosynovitis is a painful inflammatory  condition affecting the first dorsal compartment of the wrist, involving the abductor pollicis longus (APL) and extensor  pollicis brevis (EPB) tendons. This condition is caused from  the swelling and irritation of the tendons involved in thumb  and wrist movements. It results from repetitive strain or  overuse, leading to thickening of the tendon sheath, causing  pain and impaired tendon movement.  Contributing Factors:  A) Overuse and Repetitive movements: Frequent repetitive activities that use the  hand and wrist, such as gaming, typing, lifting and gripping objects, gardening,  lifting babies (lifting babies in radial deviation long periods of time), using tools,  can irritate and cause inflammation of the thumb tendons. Increasing load and  volume on the thumb tendons in short time frames can also lead to this  condition. B) Trauma/Injury: An impact or direct hit to the thumb area can injure the tendons  and cause subsequent inflammation of the area. Having previous wrist  instability can also be a precursor to straining this region further. Treatment & Management:  1) Activity modification and Rest: Identifying aggravating factors and avoiding or  reducing these will reduce irritation and minimise the cycle of excessive  inflammation which can help with pain reduction and healing.  2) Cryotherapy: Utilising ice packs for 15-20 minutes every few hours or when very  painful can alleviate pain and control inflammation. Make sure you wrap the ice  pack in a damp towel or paper towel rather than exposing it to the skin directly.  3) Bracing: Using a thumb splica splint helps immobilise the thumb and wrist in  neutral or slight extension. This helps support the thumb and allow it to rest and heal more efficiently and comfortably.  4) Medical: Starting with lower dosed over-the-counter non-steroidal anti inflammatories (NSAIDs), can help with the pain and excessive inflammatory  components that are associated with these sprains. Second line treatments, if pain persists with the conservative approach failing, may see an individual being  recommended to have a corticosteroid injection to acutely decrease the  inflamed tendons. Referral to a hand specialist in these more persistent and  complex cases for a custom splint or further management input may be necessary.5) Exercise rehab: Exercises that look to target to increase wrist and thumb  strength and mobility. Exercises that also strengthen and focus to increase  flexibility in surrounding muscles are important too. Specialised exercises such  as tendon glides (gentle movements of the wrist/hand) can help mobilise the  tendons in their sheaths to minimise compression and encourage normalised  movements.