QUESTION: A 30 year old female office worker has developed pain in her wrist since the birth of her first child. She is having trouble picking him up and writing. What is the problem?
What is it?
DeQuervain’s Syndrome is the irritationĀ of the two tendons that insert at the base of the thumb as they pass through the extensor sheath. The extensor pollicis brevis and abductor pollicis longus muscles are responsible forĀ lifting the thumb up and away from the palm. Repetitive movements of the thumb and wrist as well as activities requiring pinching can cause pain and swelling around the tendons. Aggravating activities may includeĀ holding a baby, writing, grasping bed sheets, pulling up trousers, turning keys, and carrying plates.
Clinical Examinations
A hand therapist can assess you for DeQuervain’s SyndromeĀ and determine what treatment option is best for you.Ā An ultrasound can help confirm diagnosis.
Treatment
Dequervain’s SyndromeĀ can be treated in a splint which supports both the thumb and the wrist. Ā The splint will help to immobilise the affected tendons reducing inflammation and pain. Splinting may be required for 4-6weeks. Ā There areĀ a range of different splinting options; your therapist can discuss whichĀ splint design is best for you depending on yourĀ functional demands.Ā Your therapist will provide you with:
- Education aboutĀ your condition and appropriate treatment
- Range of movement exercises for uninvolved jointsĀ
- A supportive splint to immobilise, protect and support you thumb and wrist. Ā Waterproof options are available
- Activity modification to reduce flare upsĀ when caring for baby
- Techniques to help reduce pain and inflammation
- Graduated exercises for range of motion, nerve gliding, and strengthening
Surgical Treatment
Surgical review may be required if your symptoms are not settling. Ā Sometimes a cortisone injection in combination with splinting can help DeQuervain’s Syndrome. Your therapist can discuss this with you and your GP canĀ arrange a referral to a hand surgeon if required.
If you have any questions regarding DeQuervain’s Syndrome or any other a condition you have, or toĀ book an appointment, feel free toĀ contact us here. We’d be more than happy to help.
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