The condition occurs when the tendons of the thumb at the wrist become inflamed, often following repetitive use. The result is pain at the base of the thumb and extending into the lower arm. A sheath, or covering, surrounds the tendons that go to your thumb. The modified eichoff maneuver, commonly called the finkelstein s test. Jason pirozzolo provides information on this common condition, and our friends. These structures can thicken, resulting in a stenosing tenosynovitis. Dequervains tenosynovitis inflammation of the tendons of the thumb. Dequervains tenosynovitis is inflammation of the sheath the synovium that.
This surrounds the two tendons that are involved in moving the thumb. It develops when the abductor pollicis longus apl and extensor pollicis brevis epb tendons around the base of the thumb become swollen, often causing inflammation to develop. The swollen tendons and their coverings rub against the narrow tunnel through which they pass. Touch the tip of your thumb to the tip of your little finger. Once your symptoms are better, work to prevent the condition from happening again.
Dequervains tenosynovitis is inflammation of the sheath the synovium. Each flexor tendon and its sheath run through a fibroosseous tunnel fig. You may do these exercises when it is not painful to move your hand. Physiotherapy treatment can help to stretch and strengthen the affected area. Hand wrist exercises max superspecialty ortho clinic. Inflammation is usually aggravated by repetitive thumb movements and twisting motions of the wrist, causing the tendons of the thumb to rub against their surrounding sheaths. A tendon is a strong band of tissue that attaches muscle to bone. Pagonis t, ditsios k, toli p, givissis p, christodoulou a. It is a painful irritation of the tendons on the thumb side of the wrist. Dequervains tenosynovitis dequervains tenosynovitis. You may have pain when you move your wrist or pick things up. If you start treatment early, your symptoms should improve within four to six weeks. If symptoms do not improve, surgery may be an option. You will be told when to start these exercises and which ones will work best for you.
Use the following stretches and warm ups to promote blood flow, increase tissue malleability and prepare your joint for more advanced progressions. This can be due to a thickening of the soft tissues that make up the tunnel or an increase in the amount of soft tissue within the tunnel. It can be associated with pregnancy and rheumatoid disease. Pain is typically increased with gripping or rotating the wrist. Physiotherapy department dequervains tenosynovitis. Lifting the baby with your wideopen thumbs can easily lead to mommy thumb. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. Learn simple exercises to help achieve lasting recovery. On their way to the thumb, the apl and epb tendons travel side by side along the inside edge of the wrist.
A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. Here are some examples of exercises for you to try. A prospective casecontrol study was conducted to analyze the most common risk factors for dq. This irritation causes the lining around the tendon to swell, changing the shape of the lining and making movement of the tendons difficult. Dequervains pronounced dehkervanes tenosynovitis,also known as dequervains tendinitis and dequervains disease,is a condition that is caused by inflammation of tendons of the thumb at the wrist, characterized by pain and swelling in the thumb and wrist areas. Place your hand on a flat surface, with your palm up. During this time, the splint can be removed to carry out the following exercises. It causes pain at the thumb side of your wrist where the base of your thumb meets your forearm. The cause of tenosynovitis in many cases the cause is.
It is just as important to stretch the wrist as well as the tendons of the thumb. Repetitive activities requiring sideways movement of the wrist while gripping the thumb eg. Dequervains syndrome causes pain along the thumb side of the. Use your other hand to gently stretch your thumb and wrist downward until you feel the stretch on the thumb side of your wrist. Its always important to start your rehabilitation exercises by slowly warming up the injured or aggravated joints. In rheumatoid arthritis ra, flexor tenosynovitis is characterized by inflammation of the flexor tendon and the. Pain and swelling due to diffuse tenosynovitis or triggering due to a nodule at the a1 pulley14. The inflammation causes the compartment a tunnel or a sheath around the tendon to swell and enlarge, making thumb and wrist. You may do all of these exercises when the initial pain is gone. Over the last decade, texting has become more popular, and people are having more of these symptoms.
This inflammation and swelling are usually the result of trauma to the tendon from repetitive twisting motions. This can be due to a thickening of the soft tissues that make up the tunnel or an. Lift your thumb away from your palm to make a c shape. As an inflammatory condition, icing is critically important. Department of rehabilitation medicine newyorkpresbyterian. Once you can carry out the stage 1 exercises with no pain, add a small weight and increase the repetitions to 1020 times every 2 hours. There may be swelling and thickening of the sheath and it becomes very painful to move the thumb. The word tendinosis refers to a swelling of the tendons. Summit medical group is making it easier than ever for patients to seek care while limiting exposure to covid19. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist.
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