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De Quervain’s syndrome refers to pain in two of the tendons which move the thumb – the abductor pollicis longus and the extensor pollicis brevis. Inflammation may occur where the tendons glide inside a fluid-filled ‘synovial’ sheath near the thumb-side of the wrist. Inflammation of this sheath is known as tenosynovitis.
Symptoms include pain on the thumb side of the wrist. Pain may extend up the forearm and a catching or snapping may be felt when moving the thumb. Sometimes there is localised redness and swelling. While often there is no definite cause, it is more common in new mothers (when it is aggravated by picking up their baby), middle-aged people, gamers, gardeners and in those with Rheumatoid Arthritis.
Physiotherapy treatment may assist with relief of symptoms and addressing any known underlying causes. Interspersing rest and gentle exercises is usually required. Rest can be achieved by temporarily avoiding the aggravating movements and by using taping (strapping) or a splint.
At Free2Move we favour using stretchy ‘kinesio-tape’ such as Rocktape rather than using rigid strapping. Kinesio-tape does not restrict natural movement but improves sensory and movement awareness, while gently supporting the area.
Another treatment we often find effective at Free2Move is Low Level Laser Therapy (LLLT). Laser is thought to work by stimulating tissue healing while reducing pain and inflammation.
Once pain has settled Feldenkrais or Pilates may be recommended to improve the way you move. In particular it is useful to look at the suspected aggravating movements. It’s helpful to find out how they can be performed with less effort, using the large muscles of the trunk to provide the power, with the small muscles of the hand being used to gently guide direction. This helps prevent the recurrence of the problem.
In cases where there is not an adequate treatment response, clients are referred back to their doctor, who may recommend a cortisone injection. In severe, unrelenting cases, surgery may be indicated.
