Dequervains syndrome causes pain along the thumb side of the wrist which can be caused by overuse or repetitive motion. You may do these exercises when it is not painful to move your hand. The extensor pollicis brevis epb and abductor pollicis longus apl tendons and each tendon sheath are inflamed and this may result in thickening of the first dorsal extensor sheath. This surrounds the two tendons that are involved in moving the thumb. Rest it is important to limit the aggravating movements to reduce pain and allow time for the symptoms to settle. Women are three times more likely to be affected than men. A person with dequervains syndrome may have pain, tenderness, and swelling over the thumb. Once your symptoms are better, work to prevent the condition from happening again. These medications can be taken by mouth or injected into a tendon compartment.
Pagonis t, ditsios k, toli p, givissis p, christodoulou a. Workers who perform repetitive activities of the wrist and hand. The quality of current evidence in the literature is extremely poor. These women tend to develop symptoms about four to six weeks after delivery. Repetitive activities requiring sideways movement of the wrist while gripping the thumb eg. They can utilise various local modality and soft tissue treatment options to assist your recovery. It is most common among women between the ages of 30 and 50 years of age, including a small subset of women in the postpartum period. This may heal the injured wrist and thumb but the pain in your wrist and thumb after surgery can be severe. It is a common problem affecting the wrist and is usually easy to diagnose. You may do all of these exercises when the initial pain is gone.
A sheath, or covering, surrounds the tendons that go to your thumb. These motions cause the thumb tendons to become irritated or inflamed. Tendons cordlike fibers that attach muscle to bone and synovium a slick mem brane that allows the tendons to move easily. On the nature and treatment of stenosing tendovaginitis on the styloid process of the radius. Tenosynovitis of the hand and wrist treatment algorithm. Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons. A sheath, or covering, surrounds the tendons that go to. Typically, symptoms should start to improve after 4 to 6 weeks of treatment. This can limit the movement of your thumb and helps it to rest. Share in the message dialogue to help others and address questions on symptoms, diagnosis, and treatments, from medicinenets doctors. The etiology of this disease is due to repetitive and continued strain of the apl and epb tendons as they pass under a thickened and swollen extensor retinaculum.
A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. Physiotherapy department dequervains tenosynovitis. At the orthopedic clinic, we want you to live your life in full motion. Splinting we may recommend that you wear an off the shelf or custom made splint. Press the back of the hand on your injured side with your other hand to help bend your wrist. A tendon is a strong band of tissue that attaches muscle to bone. Tendons cordlike fibers that attach muscle to bone and synovium a slick membrane that allows the tendons to move easily become irritated, causing pain. Swelling on the side of the wrist and near base of the thumb. New moms have to use their wrists and hands since theyre frequently picking up and holding their babies. Expert hand doctors at franciscan health offer advanced treatment to reduce swelling and restore function. Causes making the same motions over and over, such.
Avoiding repetitive thumb movements as much as possible. Cortisone injections can be used to treat the inflammation of small areas of the body local injections, or they can be used to treat inflammation that is widespread throughout the body systemic injections. Next, stretch the hand back by pressing the fingers in a backward direction. There may be swelling and thickening of the sheath and it becomes very painful to move the thumb. The pain would be over the wrist at the base of the thumb. The word tendinosis refers to a swelling of the tendons. A person with dequervains syndrome may have pain, tenderness, and swelling over the thumb side of the wrist, as. If you start treatment early, your symptoms should improve within four to six weeks. Department of rehabilitation medicine newyorkpresbyterian. Keep the arm on your injured side straight during this exercise.
If required, the single most useful and accurate investigation is a highresolution ultrasound scan. Multiple modalities of treatment have been proposed and no definitive guidelines have been set yet. Muenchener medizinische wochenschrift 1912, 59, 56. To decrease the inflammation of the tendons, avoid repetitive movement of the thumb and gripping movements as much as possible. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. Articles related to dqv mainly compare and focus on the effectiveness of treatments. It results from an inflamed tendon at the base of your thumb. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist. Treatment may involve nonsteroidal antiinflammatory drugs nsaids. What are possible complications of the surgical treatment. Well tailor a treatment plan thats best for your lifestyle and get you back to doing the things you love.
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