de Quervains Tenosynovitis
The extensor pollicis brevis and abductor pollicis longus are tendons that run along the radial side of the wrist, over the radial styloid process. These tendons control movement of the thumb.
The extensor pollicis brevis and abductor pollicis longus pass through a tight channel, called the first dorsal compartment, which joins the forearm to the thumb. The tendons are encased by sheaths, or a covering, that run through the first dorsal compartment. The sheaths are lined with synovial fluid (synovium) so the tendons can slide easily through them.
De Quervain's tenosynovitis is the thickening of the sheaths that encase these tendons. This occurs when the tendon sheaths and synovium become irritated and inflamed. When the sheath swells the tendons have difficulties passing through. The swelling may also put pressure on the radial nerve or other nerves in the wrist resulting in pain and/or numbness.
De Quervain's syndrome is caused by repetitive overuse or hyperextension of the tendons. Frequent twisting, grasping, clenching, pinching or wringing can irritate the synovium and sheath causing swelling and inflammation.
Mothers with infants and day care workers who frequently lift babies are most commonly affected by de Quervain's tenosynovitis. However, it may also be triggered by a direct blow to the area around the radial styloid process.
Due to the cause of de Quervain's tenosynovitis, it is also referred to as mommy thumb and mother's wrist, as well as, de Quervain's disease, radial styloid tenosynovitis, de Quervain's syndrome or washerwoman's sprain.
- Pain at the base of the thumb that increases when twisting the wrist or grabbing an object
- Swelling over the thumb side of the wrist - a fluid filled cyst may form in the area
- Moving the wrist and/or thumb, grasping, or pinching is difficult
- A catching sensation when you move your thumb may also occur but is not always present
- Numbness on the thumb and back of the index finger caused the irritation of the radial nerve
- Squeaking as the tendon tries to move through the sheath
If you are experiencing wrist pain, a common test used to diagnose if it is de Quervain's tenosynovitis is the Finkelstein Test. The doctor will ask you to make a fist around the thumb of your sore wrist and turn your wrist so the thumb in on top. With your wrist relaxed, the doctor will push down on your fist, bending the wrist down. If pain is felt along the side of the wrist and base of the thumb it is a positive indicator of de Quervain's syndrome.
Surgery is not usually necessary, and is typically the option of last resort. Treating de Quervain's syndrome with home therapies such as cold compression, and Blood Flow Stimulation Therapy™ can reduce the inflammation and swelling allowing for smooth movement of your tendons once again. If surgery is required, use of these therapies following the procedure will provide optimal healing of the tendon tissue and surrounding area. This will improve your range of motion in the thumb and reduce the risk of the condition returning.
A troublesome complication of surgery for de Quervains tenosynovitis is a painful neuroma of the radial nerve as well as increased presence of scar tissue due to the invasive nature of surgery.
To reduce the chance surgery will be require, it is important to treat de Quervain's tenosynovitis as soon as possible, as any activity or strain you put on your thumb can re-injure it further. Though the pain, discomfort, and inconvenience of de Quervain's syndrome can be overwhelming, it is possible to overcome it.
Treating Your Wrist Tendon
The trick with any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of the tendon fibres as possible. Even with optimum healing, there is always less elasticity in a previously injured tendon. This will cause the tendon to hurt, during everyday activities. If you heal your injury efficiently and quickly, your chance of re-injury later on is much lower than average.
Allowing your tendon to rest is always recommended following injury. Try to avoid grasping, wringing, twisting and pinching or any other activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The tendons in the thumbs and fingers are difficult to rest completely as they are essential for daily chores and activities.
Fortunately, there are healing tools that can help treat your tendons and speed up the healing process so you can get back to a life without pain and risk of further injury. Blood Flow Stimulation Therapy™ (BFST®) promotes blood flow to heal your tendon faster and more completely which means less scar tissue formation and greater elasticity in the tissue.
Although steroid injections may provide temporary relief from the pain of tendinitis and tenosynovitis, multiple injections should be avoided as they weaken the tendon and may lead to a rupture.
Freezie Wrap® Cold Compression Therapy
Doctors recommend using cold compression as soon as possible following an acute tendon injury and re-injury to reduce pain and swelling and minimize tissue damage.
The Wrist Freezie Wrap® allows you to treat your tendon in an effective and convenient way. The wrap is versatile with Velcro attachments so you can wrap it around your hand, wrist or forearm where you need it. It's adjustable which allows you to control the compression to your comfort level.
Designed with ColdCure Technology®, the gel packs are chilled in the fridge not the freezer. This eliminates the risk of cryoburn, or 'cold burns', on your skin that can be cause by ice and strandard freezer gel packs. You can also wear the Freezie Wrap® for longer treatments so you can enjoy even more relief from your wrist or thumb pain!
Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood to the tendon and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage done to your tendon, you also limit the amount of healing that needs to occur. This is a very important step to heal your tendon faster and with less pain!
The deep cooling effect provided by the Wrist Freezie Wrap® gives you the fast, effective relief your sore tendon has been looking for!
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Inferno Wrap® Blood Flow Stimulation Therapy™
After the inflammation and swelling is gone you can begin to treat your tendon with Blood Flow Stimulation Therapy™ (BFST®). BFST® increases the amount of blood that flows naturally to your wrist to nourish your tendons and ligaments to speed healing.
Tendons receive a limited blood supply by nature and this significantly reduces the ability to heal.
By treating your tendon with BFST® you can increase your body's blood supply to the wrist and increase your body's natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and able to heal faster. Our Wrist Inferno Wrap® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.
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With these easy-to-use, home therapies you will notice incredible improvement in the health and flexibility and reduced daily pain in your wrist. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!
Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition.