De Quervain tenosynovitis is a condition that affects the area around the wrist and thumb and is more commonly seen in women compared to men. This condition affects the abductor pollicis longus and extensor pollicis brevis tendons which run along the wrist and produce movement of the thumb. Symptoms and pain result from thickening of the sheaths that surround these tendons, as well as the surrounding compartment becoming swollen. This restricts the gliding movement of the tendons as they pass beneath these sheaths. Dr Quervain's tenosynovitis can be caused from repetitive movements, sustained or continuous strain applied to the tendons involved, trauma or injury to the thumb and/or wrist. Symptoms that may be experienced for this condition can include those listed below;
Symptoms can include:
• Pain located along the thumb and wrist (thumb side aspect of wrist)
• Swelling and tenderness along the wrist
• Pain worsened by movements such as making a fist, picking up objects, moving wrist side to side
• Pain aggravated by repetitive thumb movements
Use of conservative techniques is the preferred method of treatment. Initial immobilisation and load management of the thumb and wrist region may assist with pain management, as well as limiting activities/tasks that contribute to symptom aggravation. Individualised treatment plans may include a combination of techniques such as; rest, anti-inflammatoires, manual techniques, strengthening and patient education.
In severe circumstances, conservative management may not be effective, and surgical intervention may be required. Surgery aims to provide increased range of motion, and pain relief through rease of compartmentalise pressure in the affected area. Post-operative recovery may then also involve manual therapy, strengthening and load management to assist in recovery.