Diagnosis Of De Quervain’s Tenosynovitis Thumb Pain
Diagnosis of de Quervain’s tenosynovitis is typically made via the location of the pain and associated history of thumb stress combined with a positive ‘Finkelsteins test’. The Finkelstein’s test is performed by making a fist with the thumb tucked on the inside of the fingers and then bending the wrist down towards the floor (little finger direction). Patients with de Quervain’s tenosynovitis have a positive Finkelsteins test and will experience thumb pain with this manoeuvre.
There will also generally be pain when your hand is examined and pressure is applied on the thumb side of the wrist over the path of the inflamed tendons / tendon sheath complex.
Imaging tests generally aren’t necessary to help diagnose de Quervain’s tenosynovitis however ultrasound and MRI scans can be useful when dealing with more chronic conditions that aren’t resolving with rest and treatment.
Treatment Of De Quervain’s Tenosynovitis Thumb Pain
Conservative (non-surgical) treatment for this condition is usually successful and typically once the stress on the tendon complex is removed the complaint tends to settle. It is best to address the issue prior to it becoming chronic, as typically in my experience the longer the pain has been present for the harder it is to fix.
- Rest plays a large roll in the recover, avoiding repetitive thumb movements as much as possible and avoiding pinching movements with your thumb will help things settle quicker.
- With de Quervain’s tenosynovitis complaints starting during pregnancy, or from onset following giving birth the symptoms are likely to end around the end of either the pregnancy or when the mother finishes breast-feeding.
- To assist and accelerate recovery, anti-inflammatory medication and/or cortisone injections may be used as well as the topical application of ice.
- Frequently treatment for de Quervain’s tenosynovitis is the use of splinting, wrist braces or taping to stabilise the thumb (resting the tendon and therefore helping reduce the inflammation).
- A physiotherapist can also help review how you use your wrist and thumb, giving suggestions on how to make adjustments to daily activities to help relieve stress on your wrists. As well as this physiotherapists can advise you on appropriate exercises for your wrist, hand and arm to strengthen your muscles, reduce pain and limit tendon irritation.
If the problem persists despite appropriate treatment and rest, surgery may be considered. The surgical procedure considered is to open the sheath around the tendon to release the pressure so the tendons can glide freely, however from my personal experience it is relatively uncommon to reach this point. Physiotherapy and appropriate rest and support to the thumb and tendons is usually enough to settle even the most stubborn complaints.
Who Should I See For De Quervain’s Tenosynovitis Related Thumb Pain?
If you suspect you have de Quervain’s tenosynovitis I would suggest you see your local physiotherapist or GP for confirmation of the diagnosis, and implementation of a management plan.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Treatment Of De Quervain’s Tenosynovitis should consult his or her general practitioner or physiotherapist or suitably skilled practitioner.