An overuse injury associated with the wrist occurs when the tendons around the base of the thumb are irritated or constricted. It is known as De Quervain’s syndrome and refers to a swelling of the tendons of the thumb side of the wrist.
Initially, the primary symptom is pain and tenderness along the thumb side of the wrist. It is particularly noticeable when forming a fist, grasping or gripping things, or when turning the wrist. Pain initially experienced in the wrist can progress and travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
Other symptoms may include:
Swelling seen over the thumb side of the wrist. This swelling may make it difficult to move the thumb and wrist.
A “catching” or “snapping” sensation may be felt when moving the thumb.
Numbness may be experienced on the back of the thumb and index finger. This is caused as a nerve lying on top of the tendon sheath is irritated.
Non surgical, conservative interventions are frequently successful in resolution of the inflammation associated with this condition. This may include recommendation for physical therapy intervention.
A physical therapist will design a program for you that may include:
- modalities such as ultrasound, soft tissue mobilization, or muscle stimulating techniques to reduce inflammation and assist with tendon healing
- instruction in specific stretching techniques for the wrist and thumb tendons
- designing a progressive reconditioning and strength building program to assist you to regain your full grip and thumb strength.
- splinting techniques to provide rest to the thumb and wrist
- education regarding activity modification. This involves analysis of your activities (different methods of gripping tools or athletic equipment, alternative wrist and elbow positioning with knitting activities…) to determine ways to avoid exacerbation of the tendinitis.
Other recommendations for treatment may include use of anti-inflammatory medications. In select cases, injection of corticosteroids by a physician may also be offered to help reduce swelling and pain.