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De Quervain’s Tendinitis

Introduction

De Quervain’s tendinitis occurs when the tendons around the base of the thumb become irritated or constricted. The irritation of the tendons causes them to swell, which in turn can thicken the tendons and cause pain and tenderness.

Anatomy

Two of the main tendons to the thumb pass through a tunnel located on the thumb side of the wrist. Tendons are rope-like structures that attach muscle to bone.  Tendons are covered by a slippery thin soft-tissue layer, called synovium. This layer allows the tendons to slide easily through the tunnel. Any swelling of the tendons located near these nerves can put pressure on the nerves and this can cause wrist pain or numbness in the fingers.

Causes

De Quervian’s tendinitis occurs when the tendons on the thumb side of the wrist become irritated or inflamed. The irritation causes the lining of the tendon to become swollen which changes the shape of the compartment. This makes it difficult for the tendons to be able to move as they should. This can be caused from activities that involve repetitive hand or wrist motions, muscle weakness or tightness, or excessive training.

Symptoms

The main symptom of De Quervain’s tendonitis is pain that can be felt over the thumb side of the wrist. The pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and the thumb are in use. Some people may feel a snapping sensation when moving the thumb.

Diagnosis

De Quervain’s tendinitis can be diagnosed by using the Finkelstein test. Your doctor will have you make a fist with your fingers closed over your thumb and the wrist is bent towards the little finger. This can be very painful for a person who suffers from this condition.

Treatment

Physical therapy treatment can be extremely effective in helping to resolve this condition. A physical therapist can show you exercises that will strengthen your wrist, hand, and thumb, and that will also help reduce your pain and limit the irritation to your tendons. Also, manual therapy such as massage and trigger point release, stretches, and electrotherapy can also help to improve flexibility and function in people with this condition.

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