Tenosynovitis of De Quervain's condition: Remedies, assessments, and workouts
De Quervain's tenosynovitis, also known as gamer's thumb, texter's thumb, or mommy thumb, is a common condition that affects the tendons in the thumb, causing pain and swelling at the base of the thumb. Activities such as golf, playing the piano, typing, carpentry, carrying a child, and certain pregnancy and nursing-related activities can contribute to the development of this condition.
The first line of treatment for de Quervain's tenosynovitis typically involves rest, anti-inflammatory painkillers, and wearing a splint. In some cases, a doctor may recommend steroid injections to reduce swelling or surgery, such as a release, which involves making an incision to open the tight band over the thickened tendon.
As the inflammation subsides, exercises are an essential part of the rehabilitation process. The recommended exercises primarily focus on gentle stretching and strengthening of the thumb and wrist tendons to improve mobility and reduce pain. Key exercises include the opposition stretch, where the thumb is touched to each fingertip sequentially, typically done 10 times, and wrist flexion and extension stretches, where the wrist is bent forward and backward, respectively, and held for about 30 seconds.
It is crucial to start these exercises after the acute inflammation has subsided, usually following a period of rest, immobilization with a thumb and wrist splint, and other conservative treatments such as ice application and anti-inflammatory medications. Initiating exercises too early, while the tendons are still inflamed, may worsen symptoms. Instead, begin with rest and immobilization to allow the tendon sheath swelling to decrease. Start gentle range-of-motion and stretching exercises guided by a hand therapist or healthcare provider once pain and swelling reduce. Progress gradually to strengthening exercises as tolerated to prevent recurrence.
Early consultation with a healthcare professional or hand therapist is important to tailor the timing and types of exercises based on individual severity and healing progress. This staged approach helps promote tendon healing while minimizing pain and dysfunction.
In addition to exercises, other treatment options for de Quervain's tenosynovitis may include corticosteroid injections, wearing a splint or brace, taking anti-inflammatory medication, avoiding certain activities, and, in rare cases, surgery.
De Quervain's tenosynovitis was first identified by Swiss surgeon Fritz de Quervain in 1895. If symptoms persist, it is advisable for people to consult a doctor, especially if the exercises make the pain worse or if the pain does not reduce after 4-6 weeks.
[1] Hand Therapy: Principles and Practice. 3rd edition. M. A. Coote, J. A. Henderson, and P. J. McCarthy. Elsevier, 2016. [2] De Quervain's Tenosynovitis: Diagnosis and Management. American Family Physician. 2014. [3] De Quervain's Tenosynovitis: Diagnosis and Management. UpToDate. 2019. [4] De Quervain's Tenosynovitis. Mayo Clinic. 2021. [5] De Quervain's Tenosynovitis. American Academy of Orthopaedic Surgeons. 2021.
The rehabilitation process for de Quervain's tenosynovitis often incorporates exercises that focus on gentle stretching and strengthening of the thumb and wrist tendons, such as the opposition stretch and wrist flexion and extension stretches. These exercises should be started after the acute inflammation has subsided, following rest, immobilization, and other conservative treatments like ice application and anti-inflammatory medications. Early consultation with a healthcare professional or hand therapist is crucial for tailoring the exercises based on individual severity and healing progress.
Beyond exercises, other treatment options for de Quervain's tenosynovitis may include corticosteroid injections, wearing a splint or brace, taking anti-inflammatory medication, avoiding certain activities, and, in rare cases, surgery.
De Quervain's tenosynovitis is a common condition affecting the musculoskeletal system, and it was first identified by Swiss surgeon Fritz de Quervain in 1895. Rheumatology, as a branch of science, encompasses the study and treatment of musculoskeletal disorders, including de Quervain's tenosynovitis, and plays a significant role in health-and-wellness, fitness-and-exercise, and therapies-and-treatments related to this condition.
