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DeQuervain’s Tenosynovitis

DeQuervain’s Tenosynovitis typically presents with local tenderness and swelling over the thumb side of your wrist.

What are the causes of DeQuervain’s Tenosynovitis?

  • DQT is caused by the repetitive and excessive loading of the 2 thumb tendons (abductor pollicus longus & extensor pollicus longus) as they slide under a band of connective tissue at the wrist (the extensor retinaculum).
  • It’s linked to a degenerative mechanism where there is thickening of the tendon sheaths and retinaculum but some studies have also shown inflammatory cells which may be the reason symptoms can be reduced with anti-inflammatory treatments-either injections or medication.
  • This condition is more prevalent in pregnancy(during and post) due to the combination of fluid retention, hormonal changes & the mechanical irritation of repetitive lifting a newborn. (9)
  • Women aged 30-50 have a higher incidence (1,2)

What is the treatment for DeQuervain’s Tenosynovitis?

DQT responds well to conservative treatment including

  • rest/ice
  • NSAID’s (medication or injection)
  • Laser (3,4,5,6)
  • Therapeutic ultrasound (8)
  • Splinting (7,8)
  • Taping
  • Stretching
  • Acupuncture
  • Advice and education

These treatments can be used in combination with good effect.

While this advice is based on most recent research, if you are experiencing symptoms please seek professional assessment and personalised advice for an individualised management for your case.

We’d love to help – call 5535 5218 to make an appointment.

 

References

1.  Mardani-Kivi M, Mobarakeh MK, Bahrami F, Hashemi-Motlagh K, Saheb-Ekhitari K, Akhoondzadeh N. (2014) Corticosteroid Injection with or without Thumb Spica cast for de Quervain’s tenosynovitis. Journal of hand Surgery. 39:1, 37-41.

2.  Wolf JM, Sturdivant RX, Owens BD. (2009) Incidence of de Quervain’s tenosynovitis in a young, active population. J Hand Surg Am. 34(1);112-5

3.  Tumilty S, Munn J, McDonough, Hurley DA, Basford JR, Baxter D. (2010). Low Level Laser Treatment of Tendinopathy: A Systematic Review with Meta-Analysis. Photomedicine and Laser Surgery. 28:1

4.  Renu Sharma, Anjeti Thukral, Sudhir Kumar, SK Bhargava. (2002) Effect of Low Level Lasers in de Quervain’s Tenosynovitis. Prospective study with ultrasonographic assessment. Physiotherapy, 88:12, 730-734.

5.  Bjordal JM, Couppe CW, Ljunggren AE (2001) Low Level Laser Therapy of Tendinopathy. Evidence of A Dose-Response Pattern. Physical Therapy Reviews. June 2001.

6.  Sharma R, Thukral A, Kumar S, Bhargava S. Effect of low level lasers in de Quervain’s tenosynovitis. Physiotherapy. 2002;88(12):730e734.

7.  Goel R, Abzug JM. (2015) de Quervain’s tenosynovitis: a review of the rehabilitative options. Hand (N.Y). 10(1);1-5.

8.  Awan WA, Babur MN, Masood T. (2017) Effectiveness of therapeutic ultrasound with or without Thumb Spica in the management of de Quervain’s disease. Journal of back and Musculoskeletal Rehabilitation. 30(4): 691-697

9.  Mak Jenson. (2018) De Quervain’s Tenosynovitis: Effective Diagnosis and Evidence-Based Treatment. 10.5772/intechopen. 82029

 

 

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Our Response to Covid-19

This page is up to date to our best knowledge, however, this is a rapidly evolving situation so we apologise for any potential delay in updating this information.

We want to reassure all our patients that we are following stringent infection control procedures in our clinic, and screen all people coming into the clinic, to exclude any patients that have any signs or symptoms consistent with Covid-19, as well as screening any patients that should be in isolation ie recently returned from overseas, or have been advised to isolate due to recent exposure with a known Covid-19 patient.

All our staff have now completed the Department of Health Covid-19 Infection Control Training.

What are we doing to minimise risk?

  • Screening patients for risk factors over the phone or through text messages before they attend appointments. Those with risk factors or symptoms are advised not to attend & to seek medical advice.
  • Hand sanitiser station at the front of the building must be used before you enter.
  • Following stringent infection control measures within the clinic. This includes
    • Disinfecting all beds, door handles, EFTPOS machine before and after each patient use.
    • Linen changed between each patient and commonly touched surfaces through the practice are cleaned regularly throughout the day.
    • Minimising the distances between clients in the waiting room- some chairs are outside undercover.
  • We have advised our team members not to come to work if they have cold or flu-like symptoms.
  • We are following all Department of Health recommendations for our type of business.

On the 30th March 2020 – the Australian government issued a statement that “People aged over 70, aged over 60 with pre-existing conditions, or Indigenous people aged over 50 should stay home wherever possible for their own protection.”

The decision to come in for physiotherapy treatment really is an individual one – if you feel that your treatment is medically necessary, and are comfortable with the risks of leaving your home and coming to physiotherapy, then rest assured that when you attend our physiotherapy clinic, we are following our strict infection control processes and doing everything we can to minimise your risk whilst in our care. However, we completely understand if you are not comfortable with coming in for treatment.

TELEHealth Consultations

We are offering telehealth consults and home visits (where suitable) for patients who cannot attend our clinic.

Read more about TELEhealth Consultations here.

Staying Healthy

  • Wash your hands often (and for 20 seconds) with soap and water
  • Cough into your elbow or use a tissue to cover your mouth when you cough or sneeze
  • Social distancing practices – Avoiding close contact with others, such as touching, including shaking hands
  • Limit contact with people who are sick, and stay home if you are sick and encourage employees to stay home when sick
  • Get 7-8 hours’ sleep a night to help your immune system stay strong
Please stay safe and take care of each other!

We are monitoring the situation very closely and will make adjustments to our business as we are further informed. Our priority is the health & well being of our patients and our staff. Thanks for your understanding.

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