de quervain’s tenosynovitis
A common overuse injury that affects the tendons which run along the outside of your thumb.
What is De Quervain’s tenosynovitis?
When the sheath surrounding the two tendons controlling thumb movement becomes inflamed, this is called de Quervains tenosynovitis.
The tendons run from the wrist to the thumb. During muscle contraction such as gripping, tension is placed on the respective tendons and the tendons may rub against the bony prominence found on the part of the wrist where the thumb is; when these forces are excessive, damage to the tendons may occur resulting in De Quervain’s tenosynovitis.
What causes De Quervain’s tenosynovitis?
Repetitive or sustained activities that place strain on the tendons on the outer/back aspect of the hand can cause de Quervain’s tenosynovitis. These activities can include sports such as: golf, bowling, racquet sports, coning and rowing or manual work including bricklaying, painting and carpentry.
It is usual for you to develop this condition after a sudden increase in activities that place stress on the thumb tendons.
Occasionally it may develop suddenly due to a direct blow to the back of the thumb.
What symptoms does someone with De Quervain’s tenosynovitis present with?
De Quervain’s tenosynovitis symptoms usually develop slowly over time and at first they may develop as an ache or stiffness in the thumb or back of wrist after doing unaccustomed or aggravating activities.
Symptoms may be:
- Swelling over the area
- Pain when moving the thumb
- Pins and needles or numbness in the thumb
- Weakness in the wrist, thumb and hand
How can De Quervain’s tenosynovitis diagnosed?
Your physiotherapist can diagnose De Quervain’s tenosynovitis by carrying out a full subjective and objective examination.
A test called Finkelstein’s test can also diagnose if you have the condition. To do the test you place your thumb in the palm of your hand, make a first around it, and bend your wrist in the direction of your little finger- if this makes the pain worse than that is considered a positive test for De Quervain’s tenosynovitis.
What treatment can Farrell Physiotherapy offer for De Quervain’s tenosynovitis?
- Apply RICE principle initially
- Soft tissue massage
- Thumb bracing/splinting
- Joint mobilisation
- Ice/heat therapy
- Advice and education
- Flexibility and strength exercises
- Dry needling
- Activity/sporting modification advice
- Sporting technique correction
- Graded return to activity plan
- Anti-inflammatory advice
In rare cases, conservative treatment may not be effective and surgery is required. Physiotherapy is also beneficial post-surgery to ensure full range of movement and strength is maintained post-op.
Benefit of physiotherapy for De Quervain’s tenosynovitis?
Physiotherapy treatment can provide great results and our aim is to get you symptom free as quickly as possible. The benefits you receive from physiotherapy will depend on your initial symptoms and goals.
Physiotherapy aims to:
- Restore function
- Reduce pain
- Prevent re-injury occurring
- Improve flexibility and range of movement
Don't let pain win...
Our Expert Physiotherapists specialise in providing the latest in physiotherapy treatments and techniques in order to get you pain free as soon as possible, cure the cause of your pain and help you to return to pre-injury levels of activity.
Furthermore, we'll also give you a bespoke exercise and rehabilitation program, and advise you on how to prevent re-injury and remain pain free.
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I have recently completed a course of treatment with Ben Farrell and am pleased to highly recommend him to others. I went to see Ben when I was suffering with extreme pain due to a trapped nerve in my neck which caused pain to radiate into my shoulder, arm and hand. I got an appointment very quickly and Ben was able to diagnose the problem and work on alleviating the pain. Part of the treatment has involved improving my longstanding poor posture which I’ve had since a child and believed was something that could not be changed. Ben has also advised me on how to continue to work on this to avoid this problem from reoccurring in the future.
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After an initial diagnosis session where Ben Farrell had quickly identified the actual problem, I then undertook a course of hands on physiotherapy and an increasing program of exercise. In view of the complexity of the problem (which I was advised had been going on for far longer than I has know), the physiotherapy program was, therefore, pretty comprehensive, however, always with excellent support and guidance from Ben along the way.
I am very pleased with the results and I am now both playing much better golf and getting a full night’s sleep. And, I have no problems lifting my arm its full range!!!! So, the next thing on the agenda will be the golf game at Benton Hall.
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One of the main things I learnt when you treated me was your ability to dispel some of the old chestnuts about joint pain. Through your physiotherapy and advice I now walk more and cycle a lot. I do not rest up when I have a flair up, I do the maximum exercise I can without causing to great a discomfort to my joints. I avoid Painkillers if at all possible.
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I would gladly recommend Farrell Physiotherapy to any person requiring physiotherapy treatment.
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