See also overview and evaluation of hand disorders. The lunate derives its name from its similarity in shape to the moon. These tendons are responsible for helping to extend the thumb, and they glide through a protective covering called a tendon sheath. This compartment contains the abductor pollicis longus. There are two tendons that straighten your thumb into a thumbs up by travelling together on the back of your thumb through a tunnel. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. Its also a good idea to know your test results and keep a list of the medicines you take. Of an initial 35 articles, only seven evaluated comparable treatments. Patients often experience increased pain and swelling after turning their wrist, making a fist, or grabbing an object. Dequervains tenosynovitis bmj therapy physiotherapy clinic. The main objective of treatment will be to reduce or eliminate the cause of irritation of the thumb tendons. These medications can be taken by mouth or injected into a tendon compartment. If you start treatment early, your symptoms should improve within four to six weeks.
Lift your thumb away from your palm to make a c shape. Keeping the wrist and thumb immobile to allow the inflammation to heal is the first step. There may be swelling and thickening of the sheath and it becomes very painful to move the thumb. They can utilise various local modality and soft tissue treatment options to assist your recovery. It is the middle carpal bone of the proximal carpal row and plays an integral part in carpal kinematics. Pain is typically increased with gripping or rotating the wrist. Dequervain s tenosynovitis can be caused by a simple strain injury to the extensor pollicus longus tendon. Effective diagnosis and evidencebased treatment find, read and cite all. The inflammation causes the compartment a tunnel or a sheath around the tendon to swell and enlarge, making thumb and wrist. Tenosynovitis, technique modification, manual therapy. My occupational therapy director ruth ramsey, otrl, edd.
Taking overthecounter antiinflammatory medication like ibuprofen can also help keep symptoms under control. Guidelines for the care and treatment of breast cancer. This is typically caused by overuse especially from activities that require forceful gripping while flexing and extending the wrist. This will take 2 to 10 days depending on the severity of the condition. Pagonis t, ditsios k, toli p, givissis p, christodoulou a. This surrounds the two tendons that are involved in moving the thumb. With a narrowing of the canal, the tendons are grinding on the canals walls. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. You may have pain when you move your wrist or pick things up. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition.
The main symptoms are pain and swelling near the base of the thumb. The cause of tenosynovitis in many cases the cause is. The first dorsal compartment at the wrist includes the tendons of the abductor pollicis longus apl and the extensor pollicis brevis epb. At hand to shoulder center of wisconsin, our subspecialty trained hand surgeons conduct a thorough examination. Conventional treatments include rest, immobilisation, oral anti.
The thumb motion is restricted by the swollen tendons. Outcome of low level lasers versus ultrasonic therapy in. Dequervains in nursing mothers 1 title page positioning. Dequervain s tenosynovitis is inflammation of the tendon on the side of the wrist at the base of the thumb. The patient was provided with a splint postoperatively and initiated occupational. Dequervains tenosynovitis is inflammation of the tendon on the side of the wrist at the base of the thumb. It s also a good idea to know your test results and keep a list of the medicines you take. Its conservative management includes nonsteroidal antiinflammatory drugs, wrist and thumb immobilization, ultrasonic therapy us th. Dequervains tenosynovitis inflammation of the tendons of the thumb.
Conservative nonsurgical treatment for this condition is. Dequervains tenosynovitis can be caused by a simple strain injury to the extensor pollicus longus tendon. Place your hand on a flat surface, with your palm up. Followup care is a key part of your treatment and safety. The tendons need to move through the canal by movements of the thumb. Inflammation is usually aggravated by repetitive thumb movements and twisting motions of the wrist, causing the tendons of the thumb to rub against their surrounding sheaths. It can be associated with pregnancy and rheumatoid disease. Typical causes include stresses such as lifting heavy grocery bags by the loops, and up lifting gardening pots.
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