What Is The Outlook For De Quervains Tendinosis
De Quervains tendinosis usually responds very well to treatment. Many people do not need surgery. Treatment with braces, anti-inflammatory medications and rest often corrects the condition. Cases that require surgery have a high success rate. However, de Quervains tendinosis does need to be treated. If it is not treated, the condition will continue to become more severe over time.
Treatment For De Quervains Thumb And Wrist Pain Without Surgery
You may be able to recover from De Quervains tenosynovitis with home treatment. Changing your activity, resting the sore thumb joint, 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.
What Are The Symptoms Of Thumb Arthritis
Pain in the thumb is the most common symptom of thumb arthritis. You might feel pain when you are pinching or gripping objects, Dr. Luo says. You may also notice a little bump at the base of your thumb, he adds, explaining that this would be a bone spur, or a projection that develops along joints as a result of inflammation, including osteoarthritis.
Other symptoms may include the following:
- Swelling and tenderness at the base of the thumb
- An ache after prolonged use of the thumb
- Loss of strength when gripping or pinching with your thumb
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Surgery For De Quervains Tenosynovitis
If noninvasive treatment doesnt improve your symptoms, or if the condition is severe, you may need thumb surgery to relieve De Quervains tenosynovitis.
Your surgeon will open the thumb compartment to give the irritated tendons more space to move. When the tunnel heals, it will leave more room for the tendons. The surgery is brief, but full recovery takes several months.
Well recommend hand therapy or occupational therapy after surgery to regain your thumb function and learn healthy ways of using your hand. Learn more about orthopedic physical therapy.
Thumb And Finger Lift
Strengthening the individual digits of the hand can help to target problem areas, such as the thumb. For this exercise, all a person requires is a flat surface.
- place both hands flat on a surface
- raise both thumbs slowly while keeping all other fingers flat
- bring the thumb back down
- repeat this for each finger of the hand
- repeat as neccesary
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Help For Thumb And Wrist Tendonitis
One of the most common causes of thumb and wrist pain is due to tendonitis. De Quervains tenosynovitis is a type of tendonitis that is frequently seen in young mothers. This causes pain on the thumb side of the wrist. The pain is worse with movement of the thumb and wrist at the same time. Opening jars, turning doorknobs, and caring for a young child can be difficult.
De Quervains Tenosynovitis Treatment
Treatment for de Quervains tenosynovitis focuses on reducing pain and swelling. It includes:
- Applying heat or ice to the affected area.
- Taking a nonsteroidal anti-inflammatory drug . These include ibuprofen or naproxen .
- Avoiding activities that cause pain and swelling. Especially avoid those that involve repetitive hand and wrist motions.
- Wearing a splint 24 hours a day for 4 to 6 weeks to rest your thumb and wrist.
- Getting injections of steroids or a local anesthetic into the tendon sheath. These injections are very effective and are used regularly.
A physical therapist or occupational therapist can show you how to change the way you move. This can reduce stress on your wrist. He or she can also teach you exercises to strengthen your muscles.
Most people notice improvement after 4 to 6 weeks of treatment. They are able to use their hands and wrists without pain once the swelling is gone.
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What Are The Symptoms Of De Quervains Tendinosis
Symptoms of de Quervains tendinosis can include:
- Pain and tenderness along the side of the wrist on the thumb side.
- Pain that gets worse as you use the hand and thumb.
- Pain that appears suddenly or develops over time.
- Pain that travels into the thumb or from the wrist to the lower arm .
- Pain or difficulty when moving the thumb, especially when grasping or pinching objects.
- Feeling snapping or popping sensation in the wrist when moving the thumb.
Pain At The Base Of The Thumb
- Accepted 9 December 2014
The bottom line
-
Encourage patients to self manage the condition with simple analgesics, joint protection, and activity modification
-
Refer patients with a history or recent trauma or a red hot swollen joint for an urgent orthopaedic opinion
A woman in her 60s presents with progressive pain at the base of her thumb, which is exacerbated by writing, lifting pans, and turning door handles.
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Pain Is The Main Symptom Of De Quervains Disease
Intense stabbing pain between the thumb and wrist is the hallmark symptom of De Quervains disease.
The pain may have a gradual or sudden onset and in some cases radiate to the forearm there may also be swelling in the wrist.
Repeated use of the hand and of the thumb in particular accentuates the pain, especially in movements requiring rotation of the wrist, such as opening a jar, or when grasping objects such as a bottle or a pot.
This is particularly true for those who make forced or repetitive movements with the wrist, such as: musicians those who embroider and sew a lot those who assiduously use the computer mouse, keyboard and mobile phone mothers who breastfeed, especially in the last period when the baby becomes heavy and supporting the head requires a great deal of effort from the tendons affected by this disease.
At the time of De Quervain, the Swiss surgeon who first described this disease, it was known as the disease of nannies and embroiderers.
Avoid Tasks That Make The Pain Worse
Try to avoid tasks that are causing the pain or making it worse. This may be anything that has a repetitive nature, such as using a screwdriver, painting or lifting heavy objects. You might be able to change the way you do some tasks to take the strain off your hands and wrists. Some conditions affecting the hand and wrist wont get better until you stop doing certain tasks.
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Keeping Your Hands And Wrists Moving
Moving your hands, wrists and fingers as much as possible can help ease pain and stiffness. This will also maintain range of movement, function and strength.
We have some exercises you can do at home. Try to do them as regularly as you can, especially if your hands and wrists are feeling stiff.
If you have carpal tunnel syndrome, talk to a physiotherapist, GP or hand therapist for specific advice on exercise.
Symptoms Of Hand Finger And Wrist Pain
Symptoms of hand, finger or wrist pain depend on the type of injury and mechanism of injury. The symptoms commonly include pain during use, swelling, and/or difficulty moving the affected area.
Treatment for hand, finger and wrist pain includes: over-the-counter pain medication, rest, ice, and elevation. In more severe injuries, immobilization or surgery may be necessary.
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Jammed Or Sprained Thumb
Trauma to the thumb may result in disruption to the ligaments, causing a sprain rather than a fracture. This kind of injury is not too surprising given the stress on the CMC joint. Thankfully jammed thumbs are simple to treat, and typically involve the use of a splint to immobilize the thumb so it can heal properly.
How Is Thumb Arthritis Treated
The first method of treatment for thumb arthritis involves wearing a soft brace to limit the movement of your thumb, which allows the joint to rest. If the condition is more serious, a hard brace can be used, and either type can be worn overnight or intermittently throughout the day.
Other noninvasive steps include taking anti-inflammatory medications, modifying your activities, and icing the joint for 5 to 15 minutes several times a day.
If these methods do not help, the next step would be to inject a steroid medication directly into the joint. The injection may provide relief for several months and can be repeated indefinitely. Both men and women typically respond well to such conservative treatments at first, and for some, they may be all that is needed. But the treatments dont stop arthritis from progressing.
When nonsurgical approaches are no longer effective, surgery is an option. The best type of surgery for you depends on a number of factors, including the progression of the disease and how painful the symptoms are. In most cases, surgery for thumb arthritis involves removing some or part of trapezium with varying ways of stabilizing the joint.
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Basal Joint Or Rheumatoid Arthritis
The cushion-like cartilage inside your thumb joint can break down as you age, causing the symptoms of thumb arthritis. Other symptoms include loss of grip strength and thumb mobility.
Thumb arthritis can be related to osteoarthritis or rheumatoid arthritis . Thumb pain at your thumb joint caused by arthritis can feel like burning, stabbing, or a more subtle creaking pain.
How Is De Quervains Disease Treated
The treatment aims to eliminate the pain by acting on the inflammation.
Initially, the approach is conservative and may use custom-made braces and anti-inflammatory drugs and treatments such as physical therapies .
Where these therapies fail to produce results, infiltration with corticosteroids with anti-inflammatory action may also be used.
If the conservative approach does not work, surgery is required.
This is a simple operation, carried out on an outpatient basis under local anaesthetic, and lasts about five minutes.
The surgeon makes a small incision in the wrist and opens up the roof of the canal through which the inflamed tendons run to increase the space available to them.
The incision does not require stitches, but a plaster is sufficient.
If the operation is performed correctly, it is conclusive and allows the patient to use his hand immediately without any limitations.
The inflammation resolves definitively within a couple of weeks.
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Things You Can Do To Avoid Making The Pain Worse
Managing your pain is the best way to treat thumb and wrist pain and will help you recover quicker.
You should do things to try and ensure your pain does not get worse.
Things you could do are:
- change how you move your hand and wrist until symptoms begin to ease
- scoop your baby up with your sore hand under their bottom – this can be more comfortable
- keep your wrist rigid – this avoids pain irritation
- avoid wrist movements like opening the lid on a jar that is quite tight
- avoid using your thumb to grip objects
Joint Protection Top Tips
Use two hands and modify tasks
Spread the load. Adapt objects to create a larger surface area to grip.
Extra grip can be added to pens, cutlery, brushes or hand rails by using tape. Cycle tape is a good option which can be found in a range of colours in cycle shops such as Halfords.
Pace yourself
Take breaks, dont try to do too much and intersperse heavier jobs with lighter ones. You can achieve more over three days of moderate activity than in one day of doing too much, followed by two days of exhaustion.
Slide, dont lift
Particularly in the kitchen, try rearranging the locations of items so that you can slide things along sides and work surfaces instead of carrying them.
Warm up before starting the day
If hands are stiff and sore first thing when you wake up, fill a sink with warm and soapy water or apply baby oil and gently exercise and massage your hands in the water.
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Experiencing Pain Opening Jars
A common frustration our hand and upper extremity specialists address is an increased weakening in gripping or pinching objects. Simple tasks, such as opening jars or turning doorknobs, can become painful and uncomfortable. Symptoms in the hand can also include sharp or burning pain when gripping or pinching, along with swelling, stiffness, and limited motion at the base of the thumb. So what is the cause of this frustrating pain getting in the way of completing everyday activities with ease?
SYMPTOMS
According to Dr. David Holt, hand and upper extremity specialist at The Center, these symptoms are caused by arthritis in the joint at the base of the thumb. Also known as carpalmetacarpal , the joint at the base of the thumb is experiencing breakdown of cartilage resulting in bone on bone friction. Unfortunately, once cartilage has broken down in our joints, it cannot be built back up again. Arthritis is a progressive, degenerative disease, and the condition may worsen over time. There are, however, a few things that can be done to help relieve pain so that the arthritis does not interfere with life as much.
DIAGNOSIS
TREATMENT OPTIONS
If these treatments are not working, surgery may provide pain relief and/or improved function. Speak with a hand specialist who can work with you to create the best treatment plan.
Learn about conservative treatment options and the surgical procedure called a carpalmetacarpal arthroplasty in this video.
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When Hand Or Wrist Pain May Mean Arthritis
Learn about the various causes of hand or wrist pain, including different kinds of arthritis.
Many forms of arthritis and related conditions that affect different parts of the hands. Common symptoms include pain, stiffness, swelling or numbness in the wrist and fingers. Pitted nails, painful ulcers or thickened skin that makes bending the fingers difficult may also occur. Here are some diseases that affect the hands.
Osteoarthritis
Osteoarthritis is the most common form of arthritis. Also known as wear and tear arthritis, OA is a chronic condition caused by the breakdown of the cartilage, which cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub together, causing stiffness, pain and loss of joint movement.
In hand OA, the joints most commonly affected by OA are the wrists, the joints at the base of the thumb, the middle finger joints and the joints closest to fingernails. In the finger joints, OA can lead to the formation of nodes .
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease caused by a faulty immune system that primarily attacks joints . The result can be joint pain, swelling, inflammation and loss of function. RA commonly affects the wrist and finger joints. RA usually affects the same joint on both sides of the body . If untreated, the disease can cause joint deformities that make it difficult to use the hands.
Juvenile Arthritis
Lupus
Psoriatic Arthritis
Examples Of Helpful Gadgets And Adapted Devices
Pouring Devices
Adapted Handles
Using pipe lagging or gripoball on handles can increase the surface area of an object making it easier to grip. www.gripoballs.com
Alternatively OXO do a range of utensils with large rubber handles.
Stockists include: Dunelm Mill, Homesense, Lakeland
Plugs
Easy Pull Plug Removal Aid
Knitting
Bamboo knitting needles
Whether youre right or left handed knit any stitch with complete freedom and support. Use your needles, Ease painful joints, Use one handed.
Dressing
Innovative fastenings make dressing easier for those who may suffer from restricted movement or lack of finger dexterity
Cutting
The angled handle of these tools keeps your hand and wrist in a natural position, making cutting and grating smooth and simple. Despite being stainless steel they are very lightweight which is ideal for someone who has very weak hands. The soft-feel black grip on the handle of the kitchen tools is non-slip making them safer to use with wet or greasy hands. The green soft-feel grip on the garden tools has a non-slip waterproof finish making the tools easy to grip even if you have wet hands.
Opening Devices
The JarKey is a jar opener that opens jars, not by twisting the lid, but by lifting the edge of it, so that the vacuum inside is released. When the vacuum is released, it is easy to unscrew the lid. Jarkey
This One Touch product works as a tin and jar opener.
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Broken Or Fractured Thumb
In some cases, a bone within the thumb may break. These injuries cause intense pain that starts at the site of the damaged bone and can radiate through the wrist and forearm.
The bone from the tip of the thumb to the knuckle is known as the distal phalange. This connects to the proximal phalange, which extends to the base of the thumb. Within the hand, the proximal phalange connects to the first metacarpal, which extends to the base of the hand.
Depending on the type of thumb fracture and its location, the thumb may also become unstable. It may move loosely from side to side.
When it occurs
Bones in the thumb may break due to impact injuries or excessive stress. Common causes include:
- falling and landing onto the thumb
- bending the thumb too far back
- twist the thumb excessively
- blunt trauma to the thumb
Treatment
If the bone fragments remain close to the break, a temporary cast may be enough to hold the fragments in place. A broken thumb may heal within 28 weeks. However, it may take longer after surgery or if the bone fragments have not shifted much from their normal positions.
During this time, a person may require regular X-rays to check that the bones remain properly aligned.
If the bone fragments have drifted far from the break, a person may require surgery to realign the fragments. A surgeon may use wire, pins, or screws to hold the fragments together while the bone heals.