Of an initial 35 articles, only seven evaluated comparable treatments. Better understanding of this disease can help gps and their patients manage its sequelae. If you start treatment early, your symptoms should improve within four to six weeks. The tendon either becomes inflamed or its sheath becomes too tight to allow normal movement. Multiple modalities of treatment have been proposed and no definitive guidelines have been set yet. The first dorsal compartment at the wrist includes the tendons of the abductor pollicis longus apl and the extensor pollicis brevis epb.
Prompt treatment results in quicker improvement and better longterm results, often helping to eliminate the need for surgery. Inflammation is usually aggravated by repetitive thumb. Once your symptoms are better, work to prevent the condition from happening again. A sheath, or covering, surrounds the tendons that go to your thumb. If symptoms do not improve, surgery may be an option. These medications can be taken by mouth or injected into a tendon compartment. The cause of tenosynovitis in many cases the cause is. Dequervains tenosynovitis bmj therapy physiotherapy clinic. If your symptoms dont get better after treatment, then you may need an. Dequervains tenosynovitis is inflammation of the sheath the synovium.
A tendon is a strong band of tissue that attaches muscle to bone. 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. Conservative nonsurgical treatment for this condition is. This surrounds the two tendons that are involved in moving the thumb. Keeping the wrist and thumb immobile to allow the inflammation to heal is the. Taking overthecounter antiinflammatory medication like ibuprofen can also help keep symptoms under control. Directly before the wrist imagine an extension from the thumb to the forearm exist a tunnel. Appropriate studies from the bibliographies of these articles were. Pagonis t, ditsios k, toli p, givissis p, christodoulou a.
Physiotherapy department dequervains tenosynovitis. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. Better understanding of this disease can help gps and their patients. Delaying treatment may lead to chronic inflammation,thickening of the tissues,and occasionally even locking of the tendon,preventing full thumb motion. As an inflammatory condition, icing is critically important. Its conservative management includes nonsteroidal antiinflammatory drugs, wrist and thumb immobilization, ultrasonic therapy us th. Dequervains tenosynovitis inflammation of the tendons of the thumb. Outcome of low level lasers versus ultrasonic therapy in. You may notice a knot on your wrist near the thumb. Other than for strictly personal use, it is not permitted to download or to forwarddistribute the text or part of it. Download the pdf to view the article, as well as its associated figures and tables. Your doctor may have tried other treatments such as a splint or. These tendons are responsible for helping to extend the thumb, and they glide through a protective covering called a tendon sheath.
Place your hand on a flat surface, with your palm up. If this makes the pain by the base of your thumb worse, the test is considered positive. It causes pain at the thumb side of your wrist where the base of your thumb meets your forearm. See also overview and evaluation of hand disorders. Efficacy of acupuncture versus local methylprednisolone acetate. Lift your thumb away from your palm to make a c shape. There may be swelling and thickening of the sheath and it becomes very painful to move the thumb. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. This is typically caused by overuse especially from activities that require forceful gripping while flexing and extending the wrist. Conservative treatments include activity modification, modalities, orthotics, and manual therapy. Two or sometmes three tendons run through this canal to the thumb. The individual is usually referred to a physiotherapist or hand specialist for treatment, including exercises.