De Quervain’s Tenosynovitis


What is De Quervain’s Tenosynovitis?

De Quervain’s occurs on the inside of the wrist and involves two thumb muscles (extensor pollicis brevis and abductor pollicis longus) that become irritated with overuse. The two thumb muscles pass through a synovial tunnel that is line with tenosynovium that helps the tendons glide. When the tenosynovium is inflamed is restricts the tendons from gliding inside the tunnel causing pain and dysfunction. This can be caused by repetitive movements over time involving grasping, pinching or squeezing. Repetitive actions or holding the wrist in a position that compresses the tendons in the synovial tunnel (moving thumb side of wrist up to your head).


Symptoms of De Quervain’s Tenosynovitis:

• Pain/swelling near the base of the thumb
• Pain with grasping/pinching
• Feeling of weakness when gripping objects
• Pain may radiate up the arm


Assessment of De Quervain’s Tenosynovitis:

You All Care Physiotherapist will ask you a series of questions about the onset and behaviour of your pain, any activities you do and will get a short history of your pain to date. They will then complete a comprehensive assessment that may include:

• Range of movement of your elbow, wrist, neck and upper back
• Ligament tests
• Nerve movement tests
• Grip and forearm muscle strength
• Muscle length
• Posture


Treatment for De Quervain’s Tenosynovitis:

Treatment can include:

• Advice and education on your condition and ways that you can help to manage the load on your tendons through minimizing activity and changing your set up at work or during your hobbies and how to self-manage your condition
• Course of anti-inflammatories
• Ultrasound
• Electrotherapy
• Muscle strengthening program
• Joint mobilisations
• Soft tissue massage
• Dry needling
• Taping


What Can You Do to Help?

Three things that you can do to help are:

1. Stopping aggravating activities:

• This gives your tendon time to rest and heal.
• It is important to make sure that when you re-commence the activity that it is pain-free.

2. Thumb splint

• Your All Care physiotherapist can provide you with a customised splint that will restrict particular thumb movements reducing irritation and allow the tendons to heal

3. Gentle Thumb Movements

• With your palm facing up move your thumb over to your pinky finger and move back into starting position. Repeat 10 times for 3 sets


To get control your wrist pain, call All Care Physiotherapy today on 1300 291 133 and get back to the activities you enjoy!