De Quervain’s tenosynovitis is a condition that is caused by inflammation of the tendons of the thumb at the wrist which straighten or bring the thumb away from the hand.
The tendons normally glide freely through a fibrous tunnel or compartment at the wrist, however, swelling of the tendons causes the tunnel to become too tight for the tendons to glide freely. Causes of De Quervain’s include repetitive pinching or gripping combined with tilting the wrist, maintaining prolonged pinch or grasp with wrist tilt toward the little finger, and infrequently a direct blow to the side of the wrist. De Quervain’s is characterized by pain, swelling and/or a “catching” of the thumb and wrist.
You may experience pain with, or be unable to perform writing activities, office tasks such as keyboarding or filing, lifting items like books or milk cartons, performing racquet sports, or other tasks requiring sustained or repetitive use of the thumb.
What therapy can do for you
If you are referred to a therapist for treatment of De Quervain’s tenosynovitis, you will initially be evaluated for the severity of your symptoms. You may be fit with a custom splint for your wrist and thumb to assist in reducing the swelling and preventing the aggravating movements. Your therapist may also use various treatment modalities to reduce the pain and inflammation including: ice, ultrasound, electrical stimulation and manual techniques.
You will be instructed in exercises to restore tendon gliding and painfree mobility while avoiding further inflammation. You will also be provided with education regarding your condition, avoidance of symptom provoking movements and activities, home and work place modification and suggestions may be assessed and incorporated also.
If pain continues to limit hand function despite conservative rehabilitation efforts, surgery may be indicated. The surgical procedure involves releasing the tendon’s compartment and freeing up the constricted tendon. Following surgery, your therapist will assist you in recovering from surgery including care for pain, swelling, wound care, mobility, scar care, function, strengthening and conditioning to prepare for return to work and home activities.