Patients suffering from De Quarvain’s Tenosynovitis have painful tendons on the thumb side of the wrist. De quarvain’s tenosynovitis is a painful condition which affects these tendons. Tendons plays the role of rope which the muscle uses to pull the bone. It becomes visible on the straightening your fingers. The tendon sheath and swelling of the tendons, can cause pain and tenderness along the thumb side of the wrist. If patient suffer from de quarvain’s tenosynovitis, it will probably hurt when you turn your wrist, make a fist or grasp anything.
There are two main tendons to the thumb which pass through a tunnel or series of pulleys, located on the thumb side of the wrist. Tendons are rope-like structures that attach muscle to bone. Tendons are covered by synovium, which is a slippery thin soft-tissue layer. This layer synovium, allows the tendons to slide easily through a fibrous tunnel called a sheath. Any thickening of the sheath or swelling of the tendons, results in increased friction and pain with certain thumb and wrist movements. It is most common in middle-aged women.
The following are some signs of De Quarvain’s tenosynovitis-
- The main symptom is that the patient may feel pain over the thumb side of the wrist. The pain may appear either gradually or suddenly.
- Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use such as while forcefully grasping objects or twisting the wrist.
- Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid filled cyst in this region.
- A “catching” or “snapping” sensation may be felt when moving the thumb.
- Pain and swelling may make it difficult to move the thumb and wrist.
- A squeaking sound as the tendons move within the swollen sheaths.
The following may become responsible for the De Quarvain’s tenosynovitis-
- Women of 40 years of age or older are much more likely to develop de quarvain’s tenosynovitis.
- The very common cause of the de quarvain’s is repetitive involvement of hand and wrist motions during your job or hobby
- If you have a wrist injury than your scar tissue can restrict the movement of your tendons.
- During pregnancy, the hormonal changes that occur can cause de Quarvain’s tenosynovitis.
- Arthritis is also an cause for the occurance of de Quarvain’s tenosynovitis.
- THE FINKELSTEIN TEST– The finkelstein test can help your doctor to confirm de quarvain’s tenosynovitis . for this test, you bend your thumb down across the palm of your hand, and then cover your thumb with your fingers. Then, bend your wrist toward your little finger. If this causes pain, you likely to have de quarvain’s tenosynovitis.
- THE LINBURG’S SIGN TEST– During this test, the patient flexes the thumb maximally onto the hypothenar eminence and actively extends the index finger as far as possible. If limited index finger extension and pain are noted, the sign is positive for de quarvain’s tenosynovitis.
- Also, no imaginary test such as x-ray, are required to diagnose de quarvain’s tenosynovitis.
- If your physiotherapist, suggest you to wear a brace or Thumb Spica splint then must wear it.
- Also ice packs are most effective treatments for de quarvain’s syndrome, so use an ice pack regularly to reduce inflammation.
- Avoid repeatedly moving your wrist in the same way.
- Try to avoid the activity that causes pain, swelling or numbness in your thumb and wrist, also note the painful activity and share with your physiotherapist.
- Ultrasound:- An ultrasound can help to reduce muscle spasms, stiffness, cramping, swelling and pain upto a great extent. It helps by sending sound waves deep inside your tissues creating a gentle heat which increases healing and blood circulation.
- TENS:- A transcutaneous electrical nerve stimulation machine stimulates your muscle with the help of variable intensities of electrical current. It reduces your muscle spasms and increases your body’s production of endorphins, your natural pain killers.
- LASER:- Laser therapy treatment is very advance method for pain relief and decrease inflamation,In physiopoint clinic we are using LASER treatment for many painful condition ,and we are getting very good result.It gives an high intensity of light into the tendon. This helps in reduction of inflammation, pain. It also motivates cell reproduction
- Wrist radial deviation strengthening
- Wrist extension,wrist flexion
- Grip strengthening, Finger spring
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