De Quervain’s Tenosynovitis

What is De Quervain’s Tenosynovitis?

De Quervain’s Tenosynovitis (DQT) is a common work-relevant condition, often seen within occupational health physiotherapy clinics as improper care can often result in lengthy sickness absence. Inflammation of the sheath surrounding the tendons at the base of the thumb can result in pain and swelling near the base of the thumb, and difficulty moving or using tour thumb, for example when gripping or pinching.

What Causes De Quervain’s Tenosynovitis?

DQT is multifactorial and so there are a number of factors that can influence your likelihood of developing symptoms, as well as the severity of symptoms, and symptoms usually develop due to a combination of these factors, not just one. These factors can include

  • Direct trauma to the wrist – scar tissue can restrict movement
  • Repetitive hand or wrist movement while gripping or pinching, such as working in the garden, screwdriver use, hand-sewing or even lifting your baby,
  • Individual factors – being female, pregnancy and being between the ages of 30-50 all increase the likelihood of developing DQT.
  • Physical wellbeing factors – medical conditions in which you are prone to inflammatory conditions, such as rheumatoid arthritis, increase the likelihood of developing DQT and the length of time it takes to recover.
  • Psychological wellbeing factors – stress, depression and anxiety all increase the likelihood of developing DQT and even increase the severity of pain and the length of time it takes to recover.

How can I help myself?

The majority of DQT cases can be treated conservatively with physiotherapy treatment and advice, however, your attitude and the actions you take are the most important factors in preventing long-term problems. The most effective way to manage symptoms of DQT are to

  1. Avoid aggravating activities as much as possible. Once symptoms have settled you can gradually increase your exposure to some of these activities, but in order to prevent recurrence of symptoms, consider changing your activities so that you minimise future exposure.
  2. Talk to your GP or pharmacist about what pain relief or anti-inflammatory medication may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication (egibuprofen) will reduce inflammation.
  3. Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.
  4. Ensure you are following all manual handling techniques correctly at home and work – keep the load close to your waist, use your legs to lift, lower or push loads as these are the most powerful muscles in the body, and work within your capability.
  5. Report any symptoms you think may be work-related. Firstly, you may have a lawful duty to report your injury. Secondly, by informing your employers they are then able to make any necessary adjustments to your workplace or working practices, either temporarily for yourself on an individual basis, or permanently to improve overall workplace wellbeing.

How can physiotherapy help?  

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm a diagnosis and work with you to help you manage your symptoms and return to normal activity by

  1. Helping you understand your condition
  2. Helping identify the factors that may have caused or be aggravating your symptoms and providing advice on how to minimise these, including manual handling or safe DSE use.
  3. Developing symptom management strategies so you always feel in control
  4. Completing ergonomic workplace assessments to minimise any work-related risk
  5. Providing an individualised exercise program to improve mobility and strength in order to address symptoms but also to prevent future episodes, including work-hardening
  6. Providing additional manual therapies that may help ease symptoms, such as
  7. Taping to reduce pressure on the tendons.
  8. Acupuncture to reduce pain
  9. Referring for additional services if required including
    1. Shockwave therapy to improve healing
    2. Corticosteroid injection to reduce pain and allow exercise

 

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