DeQuervain’s Tenosynovitis: Causes, Symptoms, Treatment and Exercises
What is DeQuervain’s Tenosynovitis?
DeQuervains tenosynovitis is a painful condition caused by an irritation of the tendons that are on the thumb side of your wrist. A tendon is the thin, ropey part of the muscle that connects the muscle to the bone. When a muscle contracts it tugs on the tendon and that pulls the bone so that our joints can move. DeQuervains is a condition where the tendons that move your thumb becomes inflamed. It is usually caused by repetitive overuse and stress of these tendons. Some activities that can lead to this injury include caring for your baby, typing on your smartphone, improper ergonomics with your mouse, video gaming, gardening and sports such as golf, tennis, badminton and even weight lifting.
What are the Symptoms of DeQuervain’s Tenosynovitis?
Most individuals with DeQuervain’s Tenosynovitis will report pain that is localized at the base of the thumb. It is not uncommon for the pain to be felt over the boney bump close to your wrist. If the condition has progressed or is persistent, you may notice swelling and redness as well. You might notice a locking or resistance when you are trying to move your thumb and any thumb or wrist movements may aggravate your symptoms. You will particularly notice pain when you are grasping or pinching with your thumb or lifting objects with your wrist in awkward positions.
How can Physiotherapy or Chiropractic Treatment Help?
Your physiotherapist or chiropractor will conduct an initial assessment to determine if you in fact have DeQuervain’s Tenosynovitis and if so what contributing factors are associated with your condition. They will then create an individualized treatment plan that targets your specific contributing issues. The physiotherapist or chiropractor will use a combination of manual therapy, soft tissue release techniques, acupuncture, laser, ultrasound and taping to help relieve your symptoms and regenerate your tendons. They will also educate you on proper wrist positioning when performing recreational activities as well as day-to-day activities. Further, they may advise you to use a brace temporarily to allow for adequate rest of injured tissues in order to allow for optimal recovery. Once your symptoms are managed, they will teach you how to build up strength in this area in order to prevent future recurrences.
What are the Best Exercises for DeQuervain’s Tenosynovitis?
- Controlled Active Range of Motion of the Thumb: For this exercise you are going to hold your hand out in front of you with your palm facing the floor. First you will move your thumb up and down the vertical direct 10x, then you will repeat that in the horizontal direction 10x. Be sure to stay in a pain free range of movement.
- Wrist Radial Deviation Strengthening: Clasp your hand gently, with your thumb up towards the ceiling, hold onto a light weight (1-2lbs) in the palm of your hand. From here deviate your wrist up and down like you are bringing a cup towards your mouth.
Perform 10-15 reps 3x/day.
- Grip and Finger Strengthening: Use a stress ball to strengthen the palm and finger flexors. Then use an elastic wrapped around the outside of your lower fingers and splay your fingers open. Repeat this for 1 min or until fatigued in both directions a few times a day.
- Forearm Stretching: Put your hands into a prayer pose, palms facing one another and your elbows pointing out to the side. Maintain this position while moving your hands side to side along the horizontal. Also, while keeping your elbows wide, try to rotate/swivel your wrists and fingers around so that the fingers are pointing ahead of you, and rotate backward so that your fingers and wrist are pointing towards your breast bone. You can also try this maneuver with the backs of your hands touching instead of your palms.
Warning– DO NOT push through pain when doing exercises or if you find the exercises aggravate your symptoms modify or stop doing them.
How to Treat DeQuervain’s Tenosynovitis at Home?
Start with applying ice over the area of soreness. 10 min ON/OFF with compression 3x/day.
You can purchase a brace that immobilizes the thumb. This can be worn when you are doing aggravating activities such as carrying groceries or typing.
Perform the active range of motion, stretching and strengthening exercises as described above.
If you are experiencing symptoms of DeQuervain’s and they are not improving within a two-week timeline. It is important that you get it assessed and treated by your trusted physiotherapist or chiropractor.
What is the Expected Recovery Time for DeQuervain’s Tenosynovitis?
If you don’t seek help quickly, your condition may worsen and take longer to recover.
When you seek treatment from an experienced physiotherapist or chiropractor in a timely manner, you will see improvement in your condition within a few sessions and will likely make a full recovery within 4 to 6 weeks. In more severe cases it could take a few months especially if it is hard for you to modify your lifestyle.
If symptoms are not improving the physical therapist or chiropractor will recommend you visit a sports medicine doctor for further investigation.
Here at Rebalance Sports Medicine, our physiotherapists have a great deal of experience dealing with DeQuervains tendonopathies in addition to many other tendonopathies. Our evidenced based, individualized multimodal approach to rehabilitation has proven to be extremely successful.
Contact us today to book your consultation. Rebalance Sports Medicine has two locations in Toronto Located in the Financial District. Yonge and Adelaide (110 Yonge Street) and University and King (155 University Avenue)
Heather Imrie, FCAMPT Physiotherapist
Heather Imrie is a FCAMPT physiotherapist practicing at Rebalance Sports Medicine in downtown Toronto.