What is DeQuervain Syndrome and what can we do about it? DeQuervain Syndrome (Tenosynovitis) is a term used to describe irritation of your abductor pollicis longus (APL) and extensor pollicis brevis (EPB), or the thumbs up muscles.
DeQuervain Tenosynovitis occurs as these muscles become entrapped in compartments at the base of the thumb. It was once thought the sheath covering these muscles became irritated. However, It is now attributed to myxoid degeneration, which describes fibroids’ development within the tissue and increased growth of vascular tissue. DeQuervain Tenosynovitis is often associated with excess gripping. Examples include lifting babies, golfing, and squeezing with the thumb and fingers.1
Signs and Symptoms
Some signs and symptoms to look for if you think you might have DeQuervain Tenosynovitis are thumb sided wrist pain that develops slowly over time2. You may have pain with both wrist and thumb movements, especially repetitive ones such as twisting and gripping.1 You have swelling in the base of the thumb, less movement of the thumb. Soreness can occur where the thumb meets the hand and continue further up the wrist. But the news is not all bad! DeQuervain’s usually resolves well with proper rest and care!1
The first step in care for DeQuervain’s rests, preferably with a splint: this prevents further damage and inflammation.3 Heat or ice can help reduce pain. Either works, and it’s best to go with your personal preference. To build off the splint, activities requiring excess thumb gripping should be limited, such as: handwriting, pinching, and squeezing.
Research reveals that exercises can help! Exercises include basic thumb movements such as extension, flexion, and abduction. These help the APL and EPB glide through their sheath. This will reduce inflammation and bring
blood flow to heal these tissues. These movements should be slow, and only as far as the thumb can move pain-free, they should feel good
(Exercise Set 1)!4 After a few days, you can
progress to tendon slides, which involve flexing the thumb while side bending the wrist towards the pinky finger. (
Exercise Set 2).4 Finally, when you feel ready, you can return to full normal activates as pain dictates
(Exercise Set 3).4
About These Exercises
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1. Satteson E, Tannan SC. De Quervain Tenosynovitis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2021 Feb 2]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK442005/ PMID: 28723034
2. Laoopugsin N, Laoopugsin S. The study of work behaviours and risks for occupational overuse syndrome. Hand Surg. World Scientific Publishing Co.; 2012 Jan 1;17(02):205–212.
3. Cavaleri R, Schabrun SM, Te M, Chipchase LS. Hand therapy versus corticosteroid injections in the treatment of de Quervain’s disease: A systematic review and meta-analysis. J Hand Ther. 2016 Jan 1;29(1):3–11.
4. De Quervain’s Tenosynovitis: A Review of the Rehabilitative Options - Ritu Goel, Joshua M. Abzug, 2015 [Internet]. [cited 2021 Feb 2]. Available from: https://journals-sagepub-com.proxy1.lib.uwo.ca/doi/full/10.1007/s11552-014-9649-3