Causes & Treatments for De Quervains Tenosynovitis
De Quervain's Tenosynovitis is a painful inflammation of the tendons within the wrist on the thumb side. These tendons are used by the muscles to pull the bones of the thumb and are thus responsible for thumb movement. When you straighten your fingers, you can see the tendons running down the back of your hand to your wrist. In De Quervain's Tenosynovitis, the tendons become inflamed and their coverings rub against the tunnel through which they run. The tunnel narrows due to the thickening of the soft tissues that makes up the tunnel. The friction from the rubbing causes immense pain at the base of your thumb, which can sometimes extend to the forearm. There are also cases in which the outside of the wrist swells and is accompanied by redness. Hand and wrist movement cause pain, especially with forceful movements.
While the cause of De Quervain's Tenosynovitis is often unknown, we do know that it is more common in middle-aged women and certain activities can trigger the disease. Overuse of the thumb, a severe injury to the thumb, repetitive grasping, and certain conditions like rheumatoid arthritis can cause De Quervain's Tenosynovitis. The disease has also been linked to pregnancy. The old theory was that De Quervain's was caused by the wringing out of cloth diapers, although it most likely has to do with changes in hormones and the swelling that accompanies pregnancy.
Identifying De Quervain's Tenosynovitis usually involves looking at the appearance of the wrist, then locating the site of the pain and tenderness on the outside of the wrist at the base of the thumb. The Finkelstein Test is commonly used to diagnose De Quervain's. It involves making a fist with your thumb placed in the palm of your hand. If pain is felt when you move your wrist, you may have De Quervain's Tenosynovitis.
Treatment normally involves rest while immobilizing your wrist for up to six weeks. Using ice can help reduce pain, as well. If this method fails, your doctor may recommend other forms of therapeutic treatment such as The Graston Technique, cold laser therapy, Active Release Technique (ART), or massage therapy.
The Graston Technique is a very effective and popular treatment for muscle, tendon, ligament, and soft tissue injuries. This treatment uses specifically designed stainless steel instruments and therapeutic exercises to detect and treat areas of swelling and inflammation. Adding Graston Technique to any treatment plan decreases recovery time and reduces the need for anti-inflammatory medication.
Cold laser therapy is a noninvasive procedure, meaning no surgery is required. It is often used to treat tendon injuries. Class IV K cold lasers use specific light energy to help decrease the inflammation of the soft tissues surrounding the wrist tendons, reduce pain, provide relief, and enhance tissue healing/regeneration. Injured cells within the scar tissue are targeted because they are more readily accepting of the photons of light that the lasers give off. This triggers increased adenosine triphosphate production within the soft tissues of the hand, which allows the cell to spend more energy on repair and healing.
Active Release Technique is a movement-based massage technique. It is used in the treatment of muscles, tendons, ligaments, fascia, and nerves. The technique is a hands-on manual therapy approach to lengthen muscles and release adhesions to tissues and nerves. The ART provider uses his or her hands to evaluate the tightness and movement of the injured area.
Massage therapy is an excellent treatment for many wrist injuries such as outside wrist sprains, thumb sprains, and hand tendon sprains. It helps reduce the pain of the swelling soft tissues by releasing serotonin, a natural pain reliever. If surgery is required for a severe case of De Quervain's Tenosynovitis, scar tissue can sometimes build up. Massage therapy helps to break down the scar tissue, which improves the recovery process.
When these treatments are incorporated into a treatment plan, patients heal faster and are less likely to have long-term pain. Our Chandler Chiropractic & Physical Therapy clinic treats patients of all ages with De Quervain's Tenosynovitis in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.