WHAT IS IT? DE QUERVAIN’S TENOSYNOVITIS
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Inflammation and thickening of the synovial sheath of tendons of the wrist and thumb.
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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.
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Also referred to as Hoffman’s disease.
Signs and symptoms
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Pain on the radial side of the wrist
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Swelling
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Crepitus
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Aggravated by the movements of thumb extension and thumb abduction
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​WHAT CAUSES IT?
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Overuse (work or sport)
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Radial side dominated sports such as rowing, kayaking, and racquet sports
PROGNOSIS
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Cortisone and anaesthetic injection may be useful.
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If conservative management fails surgery to release the tendons may be required.
HOW PHYSIO HELPS?
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Assess if your condition is de Quervain’s by conducting the Finkelstein’s test
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Organise a splint to immobilise the thumb and reduce aggravation of the tendons
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Use manual treatment including deep transverse frictions with the tendon on stretch to release any adhesions
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Use electrical therapies such as ultrasound and interferential
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Prescribe stretches and strengthening specific to your problem
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Review possible stressors, and organise ergonomic aids such as a built-up pen grip to offload the tendons
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