De Quervain’s Tenosynovitis is a common cause of pain on the thumb side of the wrist.  Physiotherapists are able to thoroughly identify, assess and treat wrist pain.  If you are experiencing wrist pain, call us today or book online.  

What is De Quervain’s Tenosynovitis ?

De Quervain’s tenosynovitis is a common condition that causes pain on the thumb side of the wrist.  It affects two tendons of the thumb:

1. The abductor pollicis longus (APL)
2. Extensor pollicis brevis (EPB).

The APL and EPB tendons travel side by side along the inside edge of the wrist. They then pass through a tunnel several centimetres before the wrist. The tunnels role is to hold the tendons in place during wrist and thumb movements. Lining the tunnel is a slippery coating which allows the two tendons to glide easily back and forth as they move the thumb. Inflammation of this coating and tendon is called known as tenosynovitis.

In de Quervain’s tenosynovitis, the inflammation constricts the movement of the tendons within the tunnel.

Causes of De Quervain’s Tenosynovitis:

Most commonly caused due to cumulative trauma from activities that require repetitive wrist and or thumb movements. Holding your hand at an angle to your wrist creates a compression point that excessively rubs the two tendons which intern leads to the inflammation.

Repeated hand and thumb motions include:

• Grasping
• Pinching
• Squeezing
• Wringing

Common wrist pain symptoms:

• Pain, swelling, and or weakness on thumb side of your wrist.
• Pain often present dropping wrist towards little finger i.e hand shake or coffee cup position.

Some examples of activities that may highlight pain or weakness include:

• Opening jars
• Wringing the hands
• Cutting with scissors
• Playing the piano
• Sewing, needlepoint or knitting
• Lifting newborn
• Carrying teapot or pouring kettle

What Physiotherapy can do for you?

Most cases of De Quervains tendonitis settle well with appropriate physiotherapy. A key component of physiotherapy in the initial stages is identifying aggravating movements and activities to limit, modify or avoid.

Activities which place large amounts of stress through the thumb tendons should be minimized to ensure that the body can break the cycle of continual aggravation and damage to begin the healing process.

Prompt and appropriate treatment is essential to ensure a speedy and an optimal recovery. Ignoring symptoms or adopting a ‘push through’ or ‘no pain, no gain’ attitudes is likely to lead to the problem becoming chronic (long term). Once the condition is chronic, the bodies healing capacity slows significantly resulting in a dramatically longer and more challenging recovery, as well as an increased likelihood of future recurrence.

What does Physiotherapy for wrist pain involve?

The chief aim of physiotherapy intervention is to enhance gliding of the APL and EPB tendons in the first dorsal compartment.

Early on the use of tape or a brace, regular icing, and Anti-inflammatory medication are utilised to reduce pain and swelling.

Shortly after the acute few days of onset manual (hands on) and exercise therapy is initiated to assist in return to hasten healing times, improve function and begin to return the patient to former functional activities. This may include: massage, joint mobilisation, dry needling, stretches, and strength exercises

In the final stages of rehabilitation, a gradual return to activity or sport is guided by the treating physiotherapist.

If you are experiencing wrist pain which could be caused by De Quervain’s tenosynovitis, see our physiotherapists for assessment and treatment by calling us or booking online.