What is it?
De Quervain’s tenosynovitis is a painful wrist condition that affects the two tendons responsible for the movement of the thumb.
What causes it?
The exact cause of de Quervain’s tenosynovitis is not currently established, however it is often associated with overuse from repeated hand and wrist movements. The condition is exacerbated by movements of the wrist while gripping e.g. wringing a cloth, holding a child or hammering a nail.
- Over 40 years old
- Jobs or activities involving repetitive wrist or hand movement.
- People that are pregnant are more at risk
- If you’re looking after a baby. Repetitive lifting of a child can cause irritation to the wrist tendons
- Females are twice as likely to get de Quervain’s compared to males
What are the symptoms?
- Experience pain when moving the thumb or wrist, especially when grasping or pinching
- Painful wrist, at the base of the thumb
- Swelling around the wrist area
Physiotherapy treatment options
Stage 1: reduce pain and swelling
- Ice massage: to reduce inflammation and desensitise the area
- Wrist splinting with thumb spica: to reduce tendon friction and irritation. Research suggests wearing a splint only if pain increases, in most cases pain-free movement is encouraged for more lasting relief.
- Activity / workplace modification (e.g. desk height, keyboard and mouse use) with wrist and thumb in neutral position to avoid further aggravation of tendons.
Stage 2: Promoting pain-free function and return to activity
- Mobilisation of wrist bones with movement of the wrist and thumb
- Isolated eccentric strengthening exercises of muscles surrounding the wrist and thumb
- Patient specific Functional exercises for return to activity / work.
- In some cases therapeutic ultrasound and soft tissue mobilisation can be effective.
Goel, R., & Abzug, J. (2015). de Quervain’s tenosynovitis: a review of the rehabilitative options