​ASKPHYSIO

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.

Pain on the radial side of the wrist

Swelling

Crepitus

Aggravated by the movements of thumb extension and thumb abduction

Overuse (work or sport)

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

Cortisone and anaesthetic injection may be useful.

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

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