Treatment options for de quervain's tenosynovitis De Quervain’s tenosynovitis (DQTS), also known as chronic stenotic tenosynovitis and de Quervain’s disease (DQD), is a condition affecting the thumb extensor tendons and...
Treatment options for de quervain's tenosynovitis De Quervain’s tenosynovitis (DQTS), also known as chronic stenotic tenosynovitis and de Quervain’s disease (DQD), is a condition affecting the thumb extensor tendons and has many non surgical and operative treatments. It is a disorder characterized by pain of varying degrees of severity in the radial side of the wrist due to restricted gliding of the tendons of abductor pollicis longus and extensor pollicis brevis in the fibro-osseous canal of the first dorsal compartment of the wrist. Around 75 percent of cases occur in women.
Case A 36 year old first time mother presents to your clinic with right wrist pain. Her baby is now 3 months old. She states she was gripping very tightly on the bed while delivering and has had some wrist pain since then.
She has pain with thumb extension and exquisite pain with Finkelstein test. What is the most effective nonsurgical monotherapy treatment option? A) Corticosteroid injection into first dorsal compartment B) Thumb spica splint for 3-6 weeks C) Occupational therapy paired with ultrasound D) Short arm cast for 3-6 weeks There is debate in regards to the etiology of DQTS with one report indicating degenerative changes that narrow the fibro-osseous canal and thicken the tendon sheath.
Immunohistochemically demonstrated the presence of inflammatory cells and higher levels of infiltration factors in de Quervain's disease retinaculum, and that tissue inflammation and angiogenesis occurred and increased with progression of the disease. The general consensus is that it is not an inflammatory condition. The prevalence rate of de Quervain's disease in the general population is 0.5% for males and 1.3% for females.
Other reports show the risk of de Quervain's disease is relatively higher in the black race and in occupations involving repetitive use of hand. NON-surgical management Nonsurgical treatment is the primary treatment of choice for DQTS and many options exist. The goal of treatment is pain relief and restoration of a fully functioning hand and wrist.
If you are experiencing symptoms that may be related to treatment options for de quervain's tenosynovitis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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