Understanding De Quervain’s Tenosynovitis: How Physiotherapy Can Help Relieve Pain and Restore Function

De Quervain’s tenosynovitis is a painful condition that affects the tendons located on the thumb side of the wrist. It is characterized by inflammation of the sheath surrounding the abductor pollicis longus and extensor pollicis brevis tendons. This condition can arise from repetitive wrist and thumb movements, making it common among individuals engaged in activities that involve gripping or grasping, especially in the post-partum period for women.

Symptoms

The hallmark symptoms of De Quervain’s tenosynovitis include:

• Pain and Tenderness: Patients typically experience pain at the base of the thumb and along the wrist, which may radiate up the forearm. This pain often worsens with activities involving hand movements, such as gripping or pinching.
• Swelling: Inflammation may lead to noticeable swelling over the thumb side of the wrist.
• Difficulty with Thumb Movement: Patients may find it challenging to perform tasks that require thumb motion, such as opening jars or using a smartphone.
• Crepitus: A grating sensation or sound may occur when moving the thumb.

Pain and Tenderness: Patients typically experience pain at the base of the thumb and along the wrist, which may radiate up the forearm. This pain often worsens with activities involving hand movements, such as gripping or pinching.

Management

Effective management of De Quervain’s tenosynovitis involves a combination of conservative and, in some cases, more invasive treatments:

• Rest: Avoiding activities that exacerbate symptoms is crucial. Resting the affected wrist can help reduce inflammation.
• Ice Therapy: Applying ice packs can alleviate swelling and provide pain relief.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen can help manage pain and inflammation.
• Splinting: A thumb spica splint can immobilize the wrist and thumb, promoting healing by minimizing movement.
• Corticosteroid Injections: For persistent symptoms, a healthcare provider may recommend corticosteroid injections to reduce inflammation.

Physiotherapy Treatment

Physiotherapy plays a vital role in the recovery process. A qualified physiotherapist will tailor a treatment plan that may include:

• Therapeutic Exercises: Gradual stretching and strengthening exercises can restore function and flexibility. These exercises focus on improving the range of motion in the wrist and thumb.
• Manual Therapy: Techniques such as joint mobilization can help reduce pain and improve mobility.
• Education and Ergonomic Advice: Patients are educated about proper wrist mechanics and provided with strategies to modify activities to prevent recurrence.
• Modalities: The use of ultrasound or electrical stimulation may help alleviate pain and promote healing.

Early diagnosis and a comprehensive management plan, including physiotherapy, are essential for effectively treating De Quervain’s tenosynovitis. If you’re experiencing symptoms, don’t wait—book into see one of our physios for a thorough evaluation and a personalized treatment approach that gets you back to doing what you love!