De Quervain Tenosynovitis
De Quervain tenosynovitis is a condition characterized by pain on the thumb side of the wrist which may be associated with swelling. In this condition thickening of the tendon sheaths around the abductor pollicis longus and extensor pollicis brevis develops where the tendons pass in through the fibro-osseous tunnel located along the radial styloid at the distal wrist. Pain is exacerbated by thumb movement and radial and ulnar deviation of the wrist.
The prevalence of De Quervain tenosynovitis is about 0.5% in men and 1.3% in women and the classic patient population is mothers of newborns who are repeatedly lifting a newborn with thumbs radially abducted and wrists going from ulnar to radial deviation.
Signs and Symptoms
- Pain near the base of your thumb
- Swelling near the base of your thumb
- Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
- A "sticking" or "stop-and-go" sensation in your thumb when moving it
Risk Factors
- Job involving repetitive movement of the wrist leading to overuse injury.
- Trauma involving the wrist may lead to tendon inflammation
- Sudden change in the schedule or intensity of any sports activity
- Baby care
- Excessive training putting increased stress on the tendon and causing multiple micro-traumas
- Certain arthritic conditions like Ankylosing spondylitis or Psoriatic arthritis, predispose patients to tendon abnormalities
JEEVISHA protocol for management of De Quervain Tenosynovitis
- Medications: In the initial course of the management of this condition, patients may be prescribed some Anti-inflammatory medications. Some other medications may be prescribed depending on the condition of the patient, which is individualized from patient to patient basis.
- Physiotherapy: Physiotherapy plays a very important role in fighting this painful condition. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first immobilizing the wrist joint for reducing pain with different and then slowly rehabilitating wrist for normal functioning.
Targeted treatment
- Ultrasound guided Peri-tendinous injection
- Ultrasound guided Dextrose prolotherapy
- Ultrasound guided Platelet rich plasma Prolotherapy