De Quervain’s
De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist. It often causes discomfort and can significantly impact your daily activities. Dr Oscar Brumby-Rendell is a renowned orthopaedic surgeon in Adelaide specialising in treating upper limb conditions, including De Quervain’s tenosynovitis, offering both surgical and non-surgical treatment options to help you regain full functionality and alleviate pain.
Understanding De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. It occurs when the two tendons around the base of the thumb become swollen, causing the sheath (covering) around the tendons to become inflamed. This inflammation can lead to pain and tenderness, especially when making a fist, grasping, or turning the wrist.
Causes of De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is often caused by overuse or repetitive movements of the wrist and thumb. Common causes include:
- Repeated movements such as gripping, pinching, wringing, or lifting
- A direct blow to the wrist or tendon area
- Conditions like rheumatoid arthritis.
Symptoms of De Quervain’s Tenosynovitis
- Pain and swelling near the base of the thumb
- Difficulty moving your thumb and wrist when performing activities that involve grasping or pinching
- A “sticking” or “stop-and-go” sensation in your thumb when moving it.
This condition can make it difficult to perform common tasks such as gripping, lifting, or even writing. Early diagnosis and treatment are crucial to prevent further complications and ensure a speedy recovery.
Diagnosis of De Quervain’s Tenosynovitis
A thorough physical examination by Dr Brumby-Rendell will assess your wrist and thumb for pain, welling, and movement restrictions. This examination is essential to accurately diagnose De Quervain’s tenosynovitis.
Early and accurate diagnosis can prevent the condition from worsening and ensure that you receive the most effective treatment options. Dr Brumby-Rendell’s expertise in diagnosing musculoskeletal conditions guarantees a precise and timely assessment.
Non-Surgical Treatments
Applying heat or ice to the affected area can significantly help in managing pain and reducing inflammation. Ice is typically used to reduce swelling and numb the pain, while heat can help to relax and soothe the muscles around the affected tendons.
Over-the-counter medications, particularly anti-inflammatory medicines, can help reduce inflammation and provide pain relief. These medications are an accessible and effective first step in managing the symptoms of De Quervain’s tenosynovitis.
Avoiding activities that exacerbate the pain is crucial. Resting the wrist allows the tendons to heal without the continuous strain caused by repetitive motions. Identifying and temporarily stopping these activities can prevent the condition from worsening.
Wearing a splint can immobilise the wrist and thumb, limiting movement and reducing strain on the tendon. This helps in alleviating pain and preventing further injury, providing a supportive environment for healing.
Steroid injections into the tendon sheath can effectively reduce inflammation and pain. These injections can provide relief for several weeks or months, making them a valuable option for managing severe symptoms without resorting to surgery.
Engaging in specific exercises prescribed by a healthcare professional can help reduce stress on the wrist and improve tendon function. These exercises are designed to strengthen the muscles and improve flexibility, aiding in the recovery process.
Benefits for New Mothers Who Cannot Rest Their Wrists
New mothers, who often find it challenging to rest their wrists due to the demands of caring for an infant, can particularly benefit from these non-surgical treatments. Strategies such as wearing a splint, using proper ergonomics during childcare tasks, and applying ice or heat can help manage symptoms while allowing them to continue their daily activities.
Surgical Treatments
Indications for Surgery
Surgery is considered when non-surgical treatments such as medication, splinting, and steroid injections do not provide sufficient relief. If symptoms persist and significantly impact daily activities despite these efforts, surgical intervention may be necessary.
Procedure Details
- Surgery to Reduce Tendon Pressure: The primary goal of surgery for De Quervain’s tenosynovitis is to relieve the pressure on the tendons. This is achieved by creating more space for the tendons to move freely.
- Cutting the Swollen Tendon’s Sheath: The procedure involves making small incisions to cut the sheath (covering) around the swollen tendon. This allows the tendons to glide more smoothly, reducing pain and improving movement.
- Minimally Invasive Techniques: Whenever possible, minimally invasive techniques are used to perform the surgery. These techniques involve smaller incisions, which can lead to quicker recovery times and reduced risk of complications.
The surgery is performed in a hospital operating theatre to ensure the highest standards of safety and care. Dr Oscar Brumby-Rendell and his team will provide a sterile and controlled environment for the procedure.
Recovery and Rehabilitation
Immediate Post-Operative Care
You will receive detailed instructions on how to manage pain and swelling, which may include prescribed medications or over-the-counter anti-inflammatory medications, as well as instructions on applying ice packs to the surgical area to reduce swelling and discomfort. Keep your hand elevated to reduce swelling and promote blood circulation, and try to rest the wrist and thumb as much as possible.
Typical Recovery Timeline
- Initial Phase (First Few Days): During the first few days, focus on managing pain, reducing swelling, and protecting the wrist with a splint or brace. This period is crucial for the initial healing of the surgical site.
- First Few Weeks: You will begin to notice a gradual improvement in symptoms. The pain and swelling should start to subside, and you will be encouraged to start gentle movements to prevent stiffness.
- One to Three Months: Most patients experience significant improvement in symptoms within this period. By the end of the three months, you should have regained a considerable range of motion and strength. However, full recovery, including the return of full strength and flexibility, may take a few more months, depending on individual healing rates.
Physical Therapy and Exercises
A tailored physical therapy program will help restore strength and flexibility to your wrist and thumb. Dr Brumby-Rendell may refer you to a physical therapist who will guide you through exercises to improve range of motion, reduce stiffness, and strengthen surrounding muscles. You may also receive exercises to perform at home.
Returning to Normal Activities
With proper care and adherence to your rehabilitation plan, you can gradually return to your normal activities. It’s important to ease back into activities and avoid any actions that could strain the wrist and thumb during the early stages of recovery.
Typical Recovery Timeline
- Initial Phase (First Few Days): During the first few days, focus on managing pain, reducing swelling, and protecting the wrist with a splint or brace. This period is crucial for the initial healing of the surgical site.
- First Few Weeks: You will begin to notice a gradual improvement in symptoms. The pain and swelling should start to subside, and you will be encouraged to start gentle movements to prevent stiffness.
- One to Three Months: Most patients experience significant improvement in symptoms within this period. By the end of the three months, you should have regained a considerable range of motion and strength. However, full recovery, including the return of full strength and flexibility, may take a few more months, depending on individual healing rates.
Frequently Asked Questions
De Quervain’s tenosynovitis is an inflammation of the tendons on the thumb side of the wrist. It causes pain and tenderness around the base of the thumb, particularly when making a fist or moving the thumb.
Surgery involves making a small incision to release the pressure on the tendons by cutting the sheath (covering) around them. This allows the tendons to glide more freely and reduces pain.
Recovery time varies, but most patients experience significant improvement within a few weeks to a few months. Full recovery, including regaining strength and flexibility, may take longer depending on individual healing rates.
- Take breaks and use ergonomic tools.
- Regular exercises to strengthen the wrist and thumb.
- Use correct techniques in activities that involve repetitive hand motions.
Why Choose Dr Oscar Brumby-Rendell?
- Qualifications and Experience: Dr Oscar Brumby-Rendell is a locally and internationally trained orthopaedic surgeon with a fellowship through the International Bone Research Association. Located in Adelaide, he has extensive experience treating upper limb conditions, including De Quervain’s tenosynovitis.
- Patient-centred approach: Dr Brumby-Rendell is committed to providing personalised care, ensuring that each patient receives the best possible treatment tailored to their needs.
- Values: His dedication, passion, and commitment to excellence make Dr Brumby-Rendell a trusted choice for patients seeking effective treatment for De Quervain’s tenosynovitis.
Scheduling a Consultation
Don’t let De Quervain’s tenosynovitis impact your quality of life. Reach out to Dr Oscar Brumby-Rendell clinic today by calling at (08) 7077 0101 or booking online. Take the first step towards your recovery.
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