De Quervain Tenosynovitis:

De Quervain Tenosynovitis:

De Quervain’s tenosynovitis occurs when the 2 tendons around the base of your thumb become swollen.
The swelling causes the sheaths covering the tendons to become inflamed.
This puts pressure on nearby nerves, causing pain and numbness.

Anatomical view of DQ

Etiology

The tendons of the abductor pollicis longus and the extensor pollicis brevis are tightly secured against the radial styloid by the overlying extensor retinaculum.
Any thickening of the tendons from acute or repetitive trauma restrains gliding of the tendons through the sheath.
Efforts at thumb motion, especially when combined with radial or ulnar deviation of the wrist that cause pain and perpetuate the inflammation and swelling.

cause:

hobby or job involves repetitive hand and wrist motions. This is a very common cause of the de Quervain’s tenosynovitis.
injury to wrist.
Scar tissue can restrict the movement of your tendons.
In pregnancy. The hormonal changes that occur during pregnancy can cause de Quervain’s tenosynovitis.
arthritis.

Signs and symptoms

Symptoms are pain at the radial side of the wrist
spasms
tenderness
occasional burning sensation in the hand
swelling over the thumb side of the wrist
difficulty gripping with the affected side of the hand.
The onset is often gradual.
Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm.

Diagnostic test:

Finkelstein test:

First, you bend your thumb so it rests across your palm. Then you make a fist, closing your fingers over your thumb.
Last, you bend your wrist toward your little finger.
If you have tenderness or pain at the base of your thumb, you probably have de Quervain’s tenosynovitPhys.

finklestein-test

Physiotherapy treatment:

Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons.
Thumb-Spica Splint.

De Quervain splint

Use splint 24 hours a day for 4 to 6 weeks.
Apply heat or ice to the affected area.
Avoiding pinching with your thumb when moving your wrist from side to side
nonsteroidal anti-inflammatory drug,such as ibuprofen.
Avoid that activities which cause pain and swelling, especially repetitive hand and wrist motions.

exercises

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