WHAT IS IT? DE QUERVAIN’S TENOSYNOVITIS

  • Inflammation and thickening of the synovial sheath of tendons of the wrist and thumb.

  • Surrounding the muscles that extend and abduct thumb is a synovial sheath which can become inflamed.  At the lower end of the radius these tendons pass through a tunnel of bone and ligaments.

  • Also referred to as Hoffman’s disease.

Signs & Symptoms

  • Pain on the radial side of the wrist

  • Swelling

  • Crepitus

  • Aggravated by the movements of thumb extension and thumb abduction

What Causes It?

  • Overuse (work or sport)

  • Radial side dominated sports such as rowing, kayaking, and racquet sports

How to Self Manage

Prognosis

  • Cortisone and anaesthetic injection may be useful.

  • If conservative management fails surgery to release the tendons may be required.

How Physio Helps

  • Assess if your condition is de Quervain’s by conducting the Finkelstein’s test

  • Organise a splint to immobilise the thumb and reduce aggravation of the tendons

  • Use manual treatment including deep transverse frictions with the tendon on stretch to release any adhesions

  • Use electrical therapies such as ultrasound and interferential

  • Prescribe stretches and strengthening specific to your problem

  • Review possible stressors, and organise ergonomic aids such as a built-up pen grip to offload the tendons

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