De Quervain's Tenosynovitis- Thumb Pain
de Quervain's tenosynovitis is inflammation of the tendons on the inside of the wrist and forearm as they attach to the thumb. The affected tendons are called the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB). As these tendons travel down the forearm on the way to the thumb they pass through a tunnel which helps keep them in place. The tunnel is lined with a slippery coating called tenosynovium. This coating allows for the tendons to slide and glide freely. Inflammation of the tenosynovium is called tenosynovitis. When this condition affects the two tendons of the thumb it is called, de Quervain's tenosynovitis. Symptoms of deQuervain’s is characterized as pain and swelling to the inside of the wrist from the thumb to forearm. Grasping objects with the thumb and hand may become increasingly painful. The patient may notice a fluid filled sensation or squeak when moving the thumb; this is due to inflammation of the coating or tenosynovium. The diagnosis of deQuervain’s can be made with physical examination by a physician and usually confirmed with an MRI
Recommendations:
- Consult a physician if you think you have de Quervain's tenosynovitis
- Acute treatment starts with reduction of inflammation - RICE regimen (Rest, Ice, Compression, and Elevation).
- Rest, avoidance of overuse and decreasing the offending activity is fundamental in the treatment of de Quervain's tenosynovitis
- Prevention of de Quervain's tenosynovitis requires careful attention to your wrist posture and repetitive movements. Often an ergonomic work station evaluation can be helpful
- Stretch before, during, and after an activity, to allow for more joint and nerve mobility.
- Use Wrist Supports and Wrist Night Braces and thumb spica orthsis