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Printed at: 05:05:14 / 23-09-2021

DeQuervains Tenosynovitis

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What is DeQuervains Tenosynovitis/ Tendonitis?

Tendonitis and Tenosynovitis are terms used to describe an inflamed and painful tendon, the strong bands or cords of tissue that attach muscle to bone to allow movement. In general tendonitis means inflammation of the tendon whilst tenosynovitis means inflammation of the synovium, a sheath which covers some tendons and contains fluid to help the tendon move freely and smoothly.
In DeQuervains Tenosynovitis it is the two tendons involved in moving the thumb that are affected.

Problems typically occur when the tendons are overused, particularly repetitive movements such as may occur during work or sporting activities; it is also common in women after pregnancy and occasionally after an injury.

The main symptoms are pain, tenderness and sometimes swelling along the thumb and side of the wrist. The pain typically occurs when the affected area is moved and can cause reduced movement, weakness and stiffness.

It is unclear what treatment works best for tendonitis or tenosynovitis and there are a whole range of treatments that may need to be tried in order to alleviate the symptoms. These can include rest, anti-inflammatory drugs, painkillers, injections, and surgery.

Hand Therapy Treatment
Initially you will be provided with a splint to wear; usually you will be advised to wear this constantly (both during the day and at night) and only remove it when bathing or showering. If the symptoms improve then you may need some gentle exercises as you gradually reduce the amount of time you wear your splint. Constant splinting may be tried for up to 6 weeks. If it has not been effective after this period of time it is should be stopped as prolonged wear can cause joint stiffness and muscle wastage.

If there is no improvement heat therapy may be tried and you will be advised to discuss other treatment options with your doctor.

Splint Wear and Care
Splints should only been worn as directed by your hand therapist. It is important NOT to wear them longer than 6 weeks as this will affect your hand power. The metal insert should run along the inside of the arm onto the palm of the hand and along the side of the thumb, with the straps of the splint fastened over the back of the arm (see picture below).

The splint should only restrict wrist and thumb movement not the fingers. Splints can be washed in warm water, but the metal bars should be removed. When replacing the bars ensure it they are placed into the pocket the correct way and inserted into the internal fold to prevent them sliding out.