ORTHOPEDICS/HAND & WRIST/WRIST CONDITIONS
If pain arises with thumb and wrist motion, a disorder known as De Quervain’s Tenosynovitis should be firstly suspected.
De Quervain’s is the inflammation within a confined zone around the thumb base that is causing this pain.
This inflammation is caused by a tendon badly behaved called stenosing tenosynovitis, which means that the tendons at the base thumb is becoming irritated as a result of recurrent stress causing damage to these tendons and resulting inflammation.
The name comes from a Swiss physician Dr. Felix De Quervain, who defined this disorder in the late 1800s.
Since that time, research and studies has been effectuated about the cause of this disorder and various therapy steps has been described to treat this difficulty.
In addition to applying to this disorder several names such as De Quervain’s tendinosis, De Quervain’s disease, texting thumb, gamer’s thumb, or new mother’s thumb.
Patient Attained
De Quervain’s tenosynovitis is most frequently arising in persons of 30-50 years old and specifically in women.
De Quervain’s tenosynovitis can somewhat be related with pregnancy and rheumatoid disease.
De Quervain’s tenosynovitis/Causes
De Quervain’s tenosynovitis is most probably due to a wrist intensive use. This why it is commonly observed in new mothers, since picking up repeatedly the baby can cause irritation to the wrist tendons.
De Quervain’s tenosynovitis/location
Knowing that in the wrist back, there are six partitions, each one of these partition comprising a number of tendons that straighten the wrist and the fingers.
The precise location of De Quervain’s tenosynovitis is one of these partitions known as the “first dorsal compartment”.
Note that within the first dorsal compartment, there are two explicit tendons that help moving the thumb in an upwards position.
These two tendons are stated as the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB).
These two tendons slide next to each other in an adjacent closeness, working together to help controlling the thumb accurate motion.
Consequently, people with de Quervain’s tenosynovitis, the APL and the EPB become irritated and solidified, and do not slide gently next to each other.
De Quervain’s tenosynovitis/signs
De Quervain’s tenosynovitis first and main sign is thumb pain on the wrist side.
Pain may come instantly and brutally as it may develop progressively.
Other frequent symptoms may comprise: Inflammation, soreness and Grinding (crepitus)
De Quervain’s tenosynovitis/Diagnosis
Classically, diagnosis did not necessitate tests.
X–ray may be sufficient to ensure that the wrist joint alignment is normal and there are no signs of arthritis within the wrist. In addition that X-rays can obviously prove findings of arthritis at the thumb base.
Once a confusion arises about the diagnosis, an MRI test may be helpful.
Characteristically the tendons within the first dorsal partition will show thickened accompanied with inflammation around the tendons.
De Quervain’s tenosynovitis /Risk Factors
Some people may be be more disposed to the development of this disorder.
Here are Some of the risk factors for de Quervain’s tenosynovitis:
Age: childbearing or middle age persons are the most affected.
Sex: de Quervain’s tenosynovitis is more frequent in women than in men.
Activity: de Quervain’s tenosynovitis may be moreobserved in people who do particular recurrent activities.
De Quervain’s Tenosynovitis /Therapy
Wrist immobilizing and a cortisone injection are the most frequent steps to be taken with De Quervain’s tenosynovitis.
Bandage should be worn unceasingly, (day and night) for four to six weeks, to support the thumb and wrist.
Anti-inflammatory medicines and ice applying may be used to diminish pain and inflammation.
Thumb and wrist relaxation is necessary to avoid doing things that may cause pain in the tendons.
As all the other conditions and disorders, if the problem persists, a surgical process can be recommended.
Surgery is frequently performed under local anesthesia but can be performed under regional, or general anesthesia as well.
After surgery, a bandage is worn for a few weeks, and normal activities can be progressively resumed.
Physical therapy may interfere following a surgery to stimulate the normal motion range.
A Final Word
De Quervain’s tenosynovitis is one of the most frequent types of tendon irritation around the wrist.
Remember that this disorder happens most commonly in women of childbearing age, and particularly after giving birth as well.