Ligaments Tendons Or Both
Weakened ligaments are a common cause of chronic wrist pain, chronic thumb pain, and chronic hand pain because weakened ligaments lead to excessive joint instability and hypermobility. What does all this mean?
A reason that the tendons are inflamed is that they are being rubbed the wrong way. By what? The tendon sheath and other structures in the wrist/thumb/hand complex. How is this friction occurring? Because the sea of ligaments that the wrist and thumb sit in is loose, allowing for the abnormal rubbing movement.
Fixing The Abnormal Rubbing Of The Tendons
In the treatments above, doctors sought to treat the problems of De Quervains tenosynovitis with anti-inflammatories that address the symptom, not the cause. With surgery, which addresses the symptom, not the cause. In Prolotherapy treatments, we address the problems of ligament damage to the thumb and wrist area. Treatment of De Quervains tenosynovitis is not a treatment in isolation. To effectively treat this problem you need to address the problems causing it, wrist and thumb instability.
Prolotherapy is the injection of a solution for the purpose of tightening and strengthening weak tendons, ligaments, or joint capsules. Prolotherapy works by stimulating the body to repair these soft tissue structures. As we discussed above, one explanation for the lack of response to De Quervains tenosynovitis traditional conservative therapies is that their underlying problem, ligament laxity, is not being addressed.
If you would like to explore Prolotherapy as a treatment, contact our team below. If you would like to see more research please visit our articles:
Do I Need Surgery For De Quervains Tenosynovitis
The above treatments are more often than not a success when done right, but in rare cases de Quervains tenosynovitis surgery may be necessary. If you go several weeks or months without improvement, surgery may be the next course of action.
Surgery for de Quervain syndrome has a high success rate for relieving the condition. Most people recover with little to no symptoms and without future recurrences. The goal behind surgery is to open the compartment that holds the inflamed tendons so they can move freely without pain. The procedure is simple and you should be able to return home on the same day.
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Paresthesia Of The Skin
Paresthesia describes a tingling, pricking, or pins and needles feeling in the skin. This often results from damage to the peripheral nerves in the hands and wrists.
The VA rates this as mild if the symptoms only cause minimal limitations and dont impact function. Its ruled moderate if it interferes with the ability to function at full capacity.
A Word About Corticosteroids:
Corticosteroid preparations used in a medical setting are manufactured by pharmaceutical companies. These are based on cortisol, a hormone naturally produced by the adrenal glands. Increased duration of action and strength of the drug are achieved by making a slight change to the molecule. The drugs commonly used are: dexamethasone, beclomethasone, prednisolone, and triamcinolone. They are about 25-30 times stronger than cortisol. These drugs have been used for injection since about 1951 with rare complications occurring. Non-operative “conservative” treatment of trigger finger and de Quervain’s with cortisone injections may result in side effects. These include: temporary pain increase , fat atrophy, skin depigmentation, hot flashes , plus local injection pain.
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Hand And Wrist Pain From Tendon Injuries
Inflammation can strike tendons or the synovium, a sheath that lines and protects the tendon . Or tendons can degenerate and become damaged . Whatever the mechanism, the end result is a tendon that can no longer slide easily through the synovium, which causes symptoms of pain and stiffness.
There are two main tendon injuries that can affect the hand and be mistaken for carpal tunnel syndrome:
De Quervains tenosynovitisDe Quervains tenosynovitis occurs when two tendons on the top of the thumb become irritated. The irritation causes pain on the back of the thumb when an individual makes a fist or moves the wrist, plus numbness or stiffness in the thumb.
Trigger fingerWhen the tendon sheath becomes inflamed in a finger or thumb, the tendon may catch on the sheath, causing the finger to stick in a bent position, then snap back into place. Trigger finger most frequently affects the thumb or ring finger, and can also affect multiple fingers at once.
Read more about Trigger Finger on Arthritis-health.com
Who Is Prone To Develop Hand Pain
Occupations involving the repetitive use of the thumb joint, such as builders, butchers, carpenters, chefs, drummers, computers and keyboard users, engineers, housekeepers, plumbers, and painters. Other locations of hand /wrist prone to Arthritis:
- Radiocarpal joints
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Texting Too Much You May Have Dequervains Tenosynovitis
Its a common, modern-day malady. Texting thumb or mommy thumb happens when you put stress on your wrist or hand repeatedly and chronically, which can lead to pain and tenderness in the tendons at the base of the thumb and into the wrist. The medical community calls it DeQuervains tenosynovitis. If you have it, it can make it difficult to complete everyday tasks. You will experience pain anytime you rotate your wrist, pick something up or make a fist.
Repetitive hand and wrist movements can increase your risk for developing DeQuervains tenosynovitis, says Adam Strohl, M.D., hand surgeon and member of the Crozer Health /Philadelphia Hand to Shoulder Center Partnership. Most of the popular technology we use today, such as smartphones and video games, demand the type of hand and wrist overuse that can lead to problems.
Surgical Treatment De Quervains Release Or 1st Extensor Compartment Release
Surgery is sometimes required for De Quervains tenosynovitis, but only after we have tried to relieve your pain with non-surgical treatment.
The operation is performed under local or general anaesthetic. During the procedure, I make a small incision of about 2-3 cm along the thumb side of your forearm, towards the wrist. The tendon sheath is divided and explored. By dividing the sheath, I give your tendons plenty of room to move, preventing pain from forcing the tendons through the swollen tunnel.
As the final part of the procedure, your wound is sutured. I will apply a light dressing and provide you with an information sheet about wound care and exercises.
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De Quervains Tenosynovitis Treatment Should We Look Beyond Tendon Inflammation And At The Ligaments Of The Wrist And Thumb
In other cases, a woman will clearly point to a diagnosis of Mommy Wrist or Mommy Thumb.
Often women will contact us with a diagnosis of Mommy or Mommys Thumb.
This is an overuse injury in new mothers who frequently pick up and hold their new babies. In fact, holding the baby can be challenging because of the pain now generating in the wrist and thumb. They will tell us this developed a few months after baby and that since the diagnosis that they have been to a chiropractor, seen an acupuncturist, had one or multiple cortisone injections, tried CBD and some have also been referred to surgery because these treatments are not helping. Some also are breast feeding and this makes treatment options a little more worrisome. So they do stretching exercises, use splits and avoid certain movements.They have bought splits and tapes and braces. How they have changed their daily chores to compensate for the swelling and pain in their wrist. Some will tell us how they started to do things with their less dominant hand and now the less dominant hand was hurting a little.
When we ask the patient, do you have a job or hobby that requires a lot of use of your hands, they will often reply yes and then we explain that we want to explore and get down to the wear and tear aspect of their thumb pain and the treatments they are exploring.
Here is a video summary:
We have had a lot of good success in treating this problem. Here is my personal story.
Is It Time To Get A New Brace For De Quervains Tenosynovitis
Youre looking for a new brace for de quervains tenosynovitis. What do you think? Its difficult to predict future price changes. If there are no signs of production slowing, it can be worth buying now to enjoy your investment sooner. But if output is declining and prices are predicted to rise, you might want to wait until the buzz has died down before making a choice.
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Treating De Quervains Tenosynovitis Without Surgery
You may be able to recover from De Quervains tenosynovitis with home treatment. Changing your activity, resting the sore thumb, and treating thumb tendonitis with anti-inflammatory medications and heat or ice can improve the pain in a few weeks.
Depending on your injury, you may need additional treatment like:
- Splints: A special splint called a thumb spica splint can support your wrist and thumb so they can heal.
- Pain management: We use non-narcotic medications and integrative care like acupuncture to manage pain so you can heal. Find out more about orthopedic pain we treat.
- Steroid injections: Injected medications can deliver pain relief or lubrication directly to the inflamed area. Learn more about injections for joint pain.
Living With De Quervains Tenosynovitis
De Quervains tenosynovitis is a temporary condition. It generally responds well to treatment. It is important to treat de Quervains tenosynovitis. If this condition isnt treated, it can permanently limit your movement or cause the tendon sheath to burst. Once your symptoms are better, work to prevent the condition from happening again.
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How Exercises Help With De Quervains Tenosynovitis
Exercise is one part of a multifaceted approach to treating de Quervains tenosynovitis. It is commonly used along with other treatments like:
- Activity modification
Typically, occupational or physical therapy is also started early on in the process.
During rehab, your therapist will teach you specific techniques designed to increase mobility in the affected thumb tendons .
Initially, pain-free thumb and wrist range of motion exercises are performed to improve tendon gliding within the sheaths. Later, strengthening exercises may also be added to help you return to your prior activities.
Signs Of Wrist Flexor Tendonitis
Wrist flexor tendonitis is actually a type of repetitive strain injury or RSI. It almost exclusively relates the activities you do with your hands. Often, its you job. Look for the warning signs of wrist flexor tendonitis by examining your occupation and how you use your hands.
Tendinitis usually affects those who perform repetitive and high velocity, high force hand activities every day for long hours. Examples are using jackhammers, hair styling,gaming, clerical typing, and playing amusical instrument.
We already saw that the signs of carpal tunnel syndrome & tendonitis are similar. But with wrist tendinitis, symptoms are usually confined to the hand, wrist or forearm.
- Pain is the primary symptom. It can range from throbbing or soreness to persistent stabbing pain.
- The pain usually is worse as youre doing the activity, such as typing. It will normally not appear at rest.
- Only rarely will the pain seem to travel to your upper arm, shoulders, neck and back. There can be tingling, numbness, coldness, or loss of sensation in any one of these areas.
- In the fingers and hands you may see a loss of grip strength or dexterity. You may also experience low muscular endurance, weakness, and fatigue.Only on rare occasions will you experience pain or numbness as you lie in bed.
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What Are The Early Signs
Typically, the symptoms start out slowly, with burning, numbness, tingling, or pain. You might feel it in your thumb and any of your fingers, but not your pinkie. The strange feeling may also travel up your forearm.
Often, symptoms start at night. Thatâs because most people sleep with their wrists bent, which causes pressure on the median nerve. You might wake up feeling like you need to shake your hands out.
As your condition gets worse, you may notice symptoms during the day, as well. This often happens when youâre doing something where your wrist is bent up or down for a long time, like driving a car, reading a newspaper, or holding your phone.
At first, symptoms tend to come and go. But over time, they occur more often and become worse.
You might also notice other symptoms:
- Your fingers feel swollen, even though they donât look like it.
- Pain and tingling travel up your forearm to your shoulder.
- âShocksâ come and go in your thumb and fingers.
Over time, carpal tunnel can also affect your grip and ability to pinch. Here are some things that could be happening:
- You drop things more often .
- Youâre having a hard time working with small objects, like the buttons on your shirt.
- Itâs harder to make a fist than it used to be.
In more severe cases, you can lose muscle at the base of your thumb. Or you may no longer be able to tell hot from cold just by touch.
How To Choose The Most Popular Brace For De Quervains Tenosynovitis
The three most crucial criteria to consider are price, quality, and popularity.Price is an obvious factor to consider, as you want to ensure it is acceptable for your needs.Quality should also be examined because buying a low-quality goods will not help you achieve your main aim of obtaining the best product.Finally, while not as obvious as price or quality, popularity can be just as significant as both when it comes to attracting new customers.
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How Is It Diagnosed
Your doctor will check for swelling, tenderness, or numbness around the base of the thumb. There may also be crackling or popping when you move your thumb.
Your doctor may or may not use the Finkelstein test to help diagnose de Quervain’s. To do this test, make a fist with your thumb inside. Then bend your wrist outward toward your little finger. If you feel pain on the thumb side of your wrist, then you most likely have de Quervain’s.
The Finkelstein test is done to make sure that you do not have a different problem, such as arthritis in the bottom of your thumb or intersection syndrome. Both of these problems affect the same area of the hand and wrist as de Quervain’s.
Benefits Of Kinesiology Taping
Pain Relief via Structural Support for Weak or Injured Body Parts
Kinesiology tape is a flexible elastic tape that moves with your body. The supple elasticity provides supports to your body parts without the tape slipping.
Kinesiology tape potentially assists your muscle strength via physical assistance. It also provides tactile feedback through the skin, e.g. proprioception boost. This phenomenon may help both the non-disabled athlete to enhance their performance and hypotonic, e.g. children with low muscle tone.
Kinesiology provides a passive lift to your skin via its elastic properties. This vacuum effect allows your lymphatic and venous drainage systems to drain and swollen or bruised tissue quicker than without the kinesiology tape.
It is also thought that this same principle can assist the removal of exercise byproducts like lactic acid that may contribute to post-exercise soreness, e.g. delayed onset muscle soreness .
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People Should Get A Multi
A July 2020 study in the journal Plastic and Reconstructive Surgery gave us this observation about the realities of splint and cortisone treatments. Here is what the researchers of this study said:
A multimodal approach using splint therapy and corticosteroid injections appears to be more beneficial than either used in isolation. Although there exists some evidence showing that multipoint injection techniques and multiple injections before surgical referral may provide benefit over a single point injection technique and a single injection before surgery, corticosteroid use is not benign and should thus be performed with caution.
This is where Prolotherapy injections can be beneficial. Prolotherapy is a simple sugar or dextrose injections. It can be given to many patients in larger and more frequent doses because of the low risk or side effects of treatment. Prolotherapy is an injection that can be given multiple times within one treatment and this treatment can be offered multiple times.
Ganglion Cyst Aspirations And Infiltrations
A ganglion cyst is a thick fluid-filled sac, usually appears in the middle of the back of the wrist or front of the wrist on the thumb side.
- Not harmful, but It can be painful at times.
- It looks and feels like a smooth lump under the skin.
A ganglion cyst sometimes resolves on its own, other times, it requires aspiration of cystic fluid. Diagnostic ultrasound ensures the diagnosis of cyst and accurately aspirate the fluid/gel.
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Your Experts In De Quervains Relief
De Quervain syndrome is fairly easy to diagnose. Still, its important to see an experienced doctor to be sure the diagnosis isnt confused with another thumb or wrist condition.
When you choose Aurora for De Quervains care, you can expect:
- Expert hand and wrist surgery: Many of our orthopedic surgeons have fellowship training in hand surgery. These doctors have additional training beyond medical school in caring for the tendons, joints and muscles of the hand.
- On-site occupational therapy: Our hand surgeons and other orthopedic specialists work directly with occupational therapists, and many are right in their clinics. Youll benefit from a comprehensive care team working together to help you feel better, fast. Learn more about occupational therapy.
- Hand therapy: Some physical therapists and occupational therapists achieve certified hand therapist status. This means theyve spent thousands of hours specializing in the hand. Hand therapy can improve your hand function and reduce pain. Learn more about hand therapy.
- Hand expertise in Milwaukee and beyond: Our Hand Service Program provides specialized hand care, with fellowship-trained hand surgeons available from Green Bay to Kenosha. Our specialists are experts at treating conditions involving your arms and hands, including problems with your fingers and thumbs.