DeQuervain’s Tenosynovitis Exercises to Relieve Thumb Pain

What is DeQuervain’s Tenosynovitis?

DeQuervain’s Tenosynovitis is a hand and wrist injury caused by inflammation and swelling within the tendons and their respective sheaths (surrounding each tendon) that move the thumb.

Normally, these tendons glide seamlessly within the tendon sheaths. Though, sometimes after repetitive use, this motion begins to cause friction and inflammation within the tendon and tendon sheath complex.

The tendons involved are the extensor pollicis brevis tendon and the abductor pollicis longus tendon. These tendons connect to the top side of the thumb and help to lift the thumb upwards and outwards away from the hand.

Causes of DeQuervain’s Tenosynovitis

The causes of DeQuervain’s Tenosynovitis include:

1. Excessive gripping, lifting, or twisting activities

2. Repetitive thumb motion (typing, gaming, cellphone texting)

DeQuervain’s Tenosynovitis is generally considered an overuse, friction condition as the tendon and tendon sheaths become inflamed over time with excessive use of the hand and wrist.

How is DeQuervain’s Tenosynovitis Diagnosed?

This painful condition typically affects people ages 30-50 with women suffering from it more often than men.

As mentioned before, DeQuervain’s Tenosynovitis is an overuse injury, so one can expect that the initial onset of this type of thumb pain occurs gradually after the individual has performed some kind of repetitive gripping, lifting, twisting, or manipulating activities.

This condition is generally easy to diagnose as there will be pain, tenderness, and swelling along the thumb tendons that are located at the top/inside of the wrist and hand.

The pain is usually described as an aching, burning, and/or pulling sensation.

An easy-to-perform clinical test that you can perform at home is to make a fist with your hand while holding the thumb against the palm of the hand, then gently tilt the hand down towards the floor (see picture below). This is called the Finkelstein Stretch Test.

This will place tension through the abductor pollicis longus and extensor pollicis brevis tendons. If the thumb/wrist pain is increased with this stretch, and then decreases once the stretch is released, it likely confirms the presence of DeQuervain’s Tenosynovitis.

Should I Wear a Wrist Brace?

Yes, I highly recommend that you wear what’s called a Thumb Spica Splint. This is a specialized type of wrist and thumb brace that will help to prevent excessive motion of the thumb by immobilizing it. This should be worn throughout the day and can even be worn at night when sleeping if you have thumb pain during that time.

9.3

Thumb Spica Splint

• THUMB AND WRIST SUPPORT FOR A VARIETY OF CONDITIONS
• COMFORT AND FREEDOM OF ESSENTIAL MOVEMENT
• SLIM DESIGN
• INNOVATIVE FEATURES FOR MAXIMIZED EFFECT
• INSTANT RELIEF AND COMFORT

Check Price

Are There Any Ointments or Creams That Can Help?

As this is an inflammatory condition, non-steroidal anti-inflammatory ointments can certainly help promote healing and reduce pain.

One such medication is Voltaren Gel (Diclofenac Sodium). This is a non-steroidal anti-inflammatory topical gel that is found over the counter at your local pharmacy. It is very effective in treating DeQuervain’s Tenosynovitis because the thumb tendons are superficial and close to the surface of the skin. The gel is massaged into the tendons and muscles and it soaks through the skin to reduce the inflammation in the tissues below. Be sure to check with your doctor before using this to ensure that it is safe for you to use.

10

Anti-Inflammatory Gel

• TWO 3.5oz/100g TUBES OF VOLTAREN PAIN GEL
• POWERFUL TOPICAL PAIN RELIEF
• NONSTEROIDAL ANTI-INFLAMMATORY
• NUMBER 1 DOCTOR RECOMMENDED TOPICAL PAIN RELIEF

Check Price

What Activities Should I Avoid to Prevent Further Aggravation of Thumb Pain?

My first and biggest recommendation for activities to avoid is:

• Let Pain Be Your Guide – DO NOT perform any repetitive activity that increases your thumb pain!

Therefore, any repetitive gripping, texting, squeezing, or twisting should try to be avoided. Your body is trying to heal the inflamed tissues and, if you continue to use the hand excessively, the inflammation and pain will only worsen.

Wearing the Thumb Spica Splint will help you in this area as it will restrict the natural thumb movements and limit your ability to overuse the thumb.

Other Causes of Thumb Pain

Other conditions that can cause thumb pain are:

1. Carpal Tunnel Syndrome

   • This causes pain, weakness, numbness, and tingling along the palm side of the thumb, index, and middle fingers.

2. Thumb Arthritis

   • Arthritis most commonly occurs at the base of the thumb where it meets the hand (Scaphoid bone).

3. Skier’s/Gamerkeeper’s Thumb

   • This injury occurs suddenly when falling onto the hand or when catching a ball awkwardly with the thumb. The force stretches the thumb outward and sprains the ulnar collateral ligament located on the inside of the thumb.

4. Scaphoid Fracture

   • The fracturing of the Scaphoid bone typically occurs when falling onto the hand.

Should I Use Ice or Heat?

Cryotherapy (cold pack) would best be used with DeQuervain’s Tenosynovitis as it can help reduce swelling and pain. Use a gel cold pack that can be easily molded around the wrist and hand for best results.

9.5

Gel Cold Pack, Large

• REUSABLE, LARGE SIZE
• LONG-LASTING GEL COLD PACK
• GREAT FOR SMALL BODY AREAS SUCH AS NECK, ELBOW, ETC.
• PROFESSIONAL QUALITY
• FILLED WITH NON-TOXIC SILICA GEL

Check Price

Heat is best used when you need to relax muscle tightness and improve joint stiffness, but not with this type of condition.

Will I Need an Injection?

A corticosteroid injection can be very effective in the treatment of this condition, but it is usually reserved for after conservative treatment has not improved the condition significantly. You will likely need to visit a hand specialist to receive this type of injection, which is typically given by a doctor who uses an ultrasound imaging device to ensure that he/she gets the steroid into the tendon sheath for maximum benefit.