De Quervain Tenosynovitis
De Quervain tenosynovitis is an inflammation of the tendons that run along the thumb side of the wrist and attach to the base of the thumb, where the tendons are constricted by the fibrous sheath called the first extensor compartment.
Causes
This injury is generally caused by overuse of the thumb or by multiple direct traumas in the area of the radial styloid. Any movement that requires the use of an object can trigger this condition.
Symptoms
The most common symptom is localised pain on the lateral surface of the wrist and sometimes mild swelling. The pain is aggravated by abduction of the thumb, a grasping action of the hand, and an ulnar deviation of the wrist.
Treatment
In the acute phase, the main concern should be to relieve the symptoms. Conservative treatment should include:
- stopping the sports or work activity that caused the repetitive or traumatic movements;
- cryotherapy and electrotherapy in the first few days.
In physiotherapy sessions, the physiotherapist and the patient will focus on alleviating the symptoms with:
- deep transverse friction massage of the injured tendons;
- relaxation massage of the periarticular muscles;
- stretching exercises;
- isometric muscle contractions of the injured and adjacent muscles;
- if the patient can tolerate it, muscle strengthening exercises should be introduced, focusing on the eccentric phase of the movement.
Once the symptoms have been relieved, the focus should be on achieving a good muscle base capable of sustaining the movements that caused the injury.
The final stage of rehabilitation should be to adapt the exercises to the sports or work activity of the patient, preferably with the help of a customised programme. In this way, we can be sure that the patient is ready to be discharged with a reduced risk of re-injury or relapse when returning to work.
If you need treatment for De Quervain Tenosynovitis, contact our physiotherapy clinics in Lisbon.
