DeQuervain's tenosynovitis is a painful condition that affects the tendons in the wrist and thumb. It is caused by overuse or repetitive movements and can be effectively treated with physiotherapy interventions such as splinting and therapeutic exercises.
Sarah Peters - BKIN(CH), R.KIN, CAT(C)
As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
Physiotherapy is a well-known and established form of treatment for musculoskeletal conditions. De Quervain's Tenosynovitis commonly affects the thumb and wrist tendons. It is characterized by pain, swelling, and difficulty in performing tasks involving the use of the thumb. This article will discuss the efficacy of physiotherapy in treating De Quervain's Tenosynovitis.
What is DeQuervain's Tenosynovitis?
DeQuervain’s Tenosynovitis is a condition caused by the irritation and inflammation of the sheath around the tendons on the thumb side of your wrist. Tendons are the thin, ropey part of the muscle that connects the muscle to the bone. When a muscle contracts, the tendons are what pull the bones to move the joints. These tendons are protected by a sheath. Tenosynovitis is similar to tendonitis, in that it involves inflammation due to overuse or improper use. However, Tenosynovitis differs in that it is an inflammation of the sheath around the tendon as opposed to the tendon itself.
Dry needling for De Quervain's Tenosynovitis can help to reduce pain and inflammation. Trigger points associated with De Quervain's can be addressed through dry-needling techniques that target specific areas of muscle tissue and nerve pathways. Additionally, physiotherapy management of De Quervain's includes soft tissue massage, joint mobilization, and stretching exercises to improve range of motion and strength. Pain management strategies such as biofeedback and transcutaneous electrical nerve stimulation (TENS) may also reduce symptoms.
What Does DeQuervain's Tenosynovitis Feel Like?
The most common symptoms of DeQuervain’s Tenosynovitis are localized pain at the base of the thumb, swelling, difficulty, or a sand paper sensation, when moving the thumb from grasping, pinching or lifting activities.
How is DeQuervain's Tenosynovitis Diagnosed?
DeQuervain's Tenosynovitis is typically diagnosed through a thorough history taking and a series of tests including palpating the area and feeling the sensations as you move your thumb. The textbook sign that you have this condition is if you can feel an unusual sand paper kind of feeling in the tendons that move your thumb with their activation.
How Can Physiotherapy Help with DeQuervain's Tenosynovitis?
Your Physiotherapist or Athletic Therapist can assess your thumb and wrist to determine if you have DeQuervain’s Tenosynovitis and determine what factors are contributing to the condition. These factors may include things like stiffness in how the joints connect at the wrist or thumb, weakness in certain muscles in the forearm, wrist or thumb.
Your therapist will then help you develop a plan to get you back to your activities or life in a pain free and fully functional way. They will provide hands-on therapy to release the tight muscles and mobilize stiff joints in the wrist or thumb. Massage Therapy in conjunction with Physiotherapy can be a great help in releasing the soft tissues in the arm and hand. Acupuncture may be used to reduce pain and promote healing of the tendon. Dry needling may be used to release trigger points in the muscle.
Restore Range of Motion and Strength
Additionally, you will be provided with a set of customized stretches and exercises to increase your mobility and strengthen the wrist and thumb. Removing the stress on the thumb tendons by lengthening the muscles that connects to them will allow them to start healing. Strengthening of the whole area will take the stress off the affected tendons by allowing other muscles to help do the work for the hand.
Remove the Underlying Causes of the Injury
Your Physiotherapist or Athletic Therapist will also help you correct any contributing muscle imbalances throughout the body that may be contributing to the cause of the injury. By removing causes of injury through exercise and manual therapy, you will be be able to start healing and return to normal.
Return you to Pain Free Living
Your Physiotherapist or Athletic Therapist will also help you to develop a plan or make recommendations for adjustments to allow healing to take place and get you back to normal daily activities in the shortest possible time. Ultimately, the healing has to start taking place faster than the break down in order for this injury to start getting better.
What are the best exercises to help with DeQuervain's Tenosynovitis?
Stretching the Tendons of the Thumb
Hold your thumb in your hand with your fingers and deviate your wrist towards your little finger.
Stretching the Forearm Flexors
With your elbow straight and your palm facing up, extend the wrist and grab the fingers with your free hand. Gently pull your fingers and wrist into extension.
Stretching the Forearm Extensors
With your elbow straight and your palm facing down, gently bend your wrist toward the floor, making a fist and pulling back using your other hand.
Strengthening the Muscles of the Thumb
Place an elastic band around your thumb and fingers. Pull thumb sideways against the elastic.
Have your forearm supported on a table or armrest with your wrist over the edge with a hammer in hand. Bend the wrist to lower the hammer's head and come back up. Adjust the difficulty by holding the handle closer or farther to the head.
Strengthening the Forearm Flexors
Place your forearm along an armrest or table with wrist hanging over the edge and palm facing up. With a weight in your hand, lift the hand towards the ceiling. Lower slowly and repeat.
Strengthening the Forearm Extensors
Hold a weight in your hand and rest your forearm on a table, so your wrist is placed over the edge of the table with the palm facing down. Lift the weight as high as possible, while keeping your forearm on the table. Then, slowly lower the weight completely. Repeat.
How Can you Prevent DeQuervain's Tenosynovitis?
DeQuervain's Tenosynovitis is an over use injury of the thumb and associated tendons. Simply avoiding overuse of this area of the hand is the best way to prevent it. You can also prevent this injury by avoiding repetitive tasks, stretching your forearms and hands frequently when you doing repetitive things and maintaining good hand and forearm strength.
What is the fastest way to heal DeQuervain's Tenosynovitis?
The fastest way to heal this and any overuse injury is to remove the offending activity. While taking a break from the activity that is causing the injury, it is also important to do Physiotherapy or Athletic Therapy to loosen the tight tendons, reduce inflammation and stretch and strengthen the wrist and hand. A home program of exercises and the use of ice to control inflammation is also likely to be recommended.
Contact Us For Help
Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer. If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities. Please reach out to us at(613) 672-2200 or firstname.lastname@example.org for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.