De Quervain's
This condition is also referred to as mother's thumb, nintendinitis and phone thumb.
When tendons at the thumb's base become inflamed, De Quervain's tenosynovitis can occur. Specifically, this condition involves the swelling of the abductor pollicis longus and the extensor pollicis brevis tendons.
These two tendons allow the thumb to move smoothly, as they are encompassed by sheaths. These tendons place pressure on surrounding nerves when inflamed and swollen, which leads to thumb pain and numbness.
Individuals with De Quervain's tenosynovitis often find it challenging to perform various movements, such as turning the wrist, gripping items or forming a fist, without experiencing pain and discomfort. Thus, this condition interferes with an individual's daily life, as thumb and wrist movements are crucial for many everyday activities.
Causes of De Quervain's
Wrist overuse is often associated with De Quervain's tenosynovitis development. De Quervain's tenosynovitis can also be developed due to tendonitis in the abductor pollicis or extensor pollicis longus tendons, and conditions can be worsened by repetitive hand movements.
New mothers often develop this condition as they regularly lift their babies, placing stress on the wrist. It can be challenging for new mothers to manage this condition, as they generally lift their child approximately 30 times each day.
Common causes of this condition also include housework, smartphone use, game controllers, and moving and carrying heavy objects. Occupations that require heavy wrist and thumb strain can also contribute to this medical condition.
Previous wrist injuries which have created scar tissue, as well as rheumatoid arthritis, can also lead to the development of De Quervain's tenosynovitis.
This condition is prominently seen in individuals who are:
- Above the age of 40
- Female
- Pregnant (as they experience various hormonal changes)
- Of African descent
Symptoms of De Quervain's
Symptoms of this condition include:
- Base of thumb swelling and pain
- Index finger and back of thumb numbness
- Inability or trouble performing pinching or grasping motions
- Squeaking sounds in tendons when moving
- Feeling that the thumb is snapping backwards or 'catching' when engaging in movement
Diagnosis of De Quervain's
You may wish to have a consultation with Dr Oscar Brumby-Rendell if you have noticed any of the above symptoms. Here, Dr Brumby-Rendell will discuss your symptoms and physically examine your hand. Dr Brumby-Rendell will assess your thumb's appearance and the location of wrist tenderness and pain to make an evidence-based diagnosis. Â
The Finkelstein manoeuvre, a type of hand assessment, will also be conducted. In this assessment, Dr Brumby-Rendell will fold your thumb across the palm, and you will be required to flex your fingers and move your wrist downward.
To ensure accurate diagnosis for complex cases, X-rays may also be conducted.
Treatments
Non-Surgical Treatments
Treatment of De Quervain's tenosynovitis aims to relieve swelling and pain. Often, this is achieved by:
- Placing heat or ice on the sore area
- Consuming over-the-counter medicines, including Ibuprofen (which is an anti-inflammatory medicine)
- Ceasing involvement in pain-inducing activities and allowing the wrist to rest
- Immobilising the wrist through splint wearing
- Administering steroids to the tendon sheath through injections
You may also be prescribed specially designed exercises to reduce wrist stress. Such conservative treatment is often preferable to new mothers who cannot rest their wrists due to changing, breastfeeding and other care responsibilities which require them to lift their babies.
Most individuals with De Quervain's tenosynovitis who have utilised one or more of these treatment options notice symptom relief after around 4 weeks.
Surgical Treatments
If conservative measures have been ineffective, surgery may be beneficial, as it can reduce tendon pressure. This surgery aims to provide the tendons with a greater amount of space to decrease pressing or rubbing against surrounding structures. Here, the swollen tendons' sheath is cut to allow freer gliding.
This procedure is conducted in a hospital operating theatre, and minimally invasive techniques are implemented where possible.
Locally and internationally trained Dr Brumby-Rendell skilfully utilises minimally invasive (keyhole) techniques and keenly implements the latest technological advancements to improve patient recovery.
Dr Brumby-Rendell will advise you on the most beneficial steps for treating your condition, and he will provide you with information regarding your surgical procedure and post-surgery recovery plan.
Post-Surgical Recovery
For rehabilitation, you will perform various exercises to strengthen muscles, promote proper tendons movement, and decrease the risk of adhesions from scar tissue. Generally, it takes approximately 6 weeks for patients to fully recommence pain-free, normal activity.
How Dr Oscar Brumby-Rendell can help
Dr Oscar Brumby-Rendell provides consultation and treatment in Adelaide for various hand and wrist conditions.
Dr Oscar Brumby-Rendell has extensive upper limb experience in areas of diagnosis, treatment and surgery. In your consultation, Dr Oscar Brumby-Rendell will develop a treatment plan with you to ensure the best possible results for your hand or wrist condition.
Click for more information regarding shoulder, hand, wrist, and elbow conditions which Dr Oscar Brumby-Rendell has experience in treating.
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