De Quervain’s Tendonitis is an overuse injury like many other tendon injuries. Continuous gripping, pinching, squeezing or wringing motions can lead to this condition. Pain in the thumb and lateral wrist, over the radius, especially during use, is common with this injury. This syndrome is more common in women than in men.
Physiotherapy Treatment for De Quervain’s Tendonitis
In acute stage:
- R.I.C.E Regime is beneficial in the first 72 hours of the injury or when inflammatory signs are present. This involves resting from aggravating activities, regular icing, the use of a compression bandage and keeping the arm elevated
- Provide a variety of hand splints to support the thumb and the wrist
- Help identify aggravating activities and suggest alternative postures
- Soft Tissue Massage
- Advice for activity modifications
In chronic stage:
- Thermal modalities
- Transverse friction massage
- Cold laser treatments are becoming more common with a high success rate for reducing localised swelling of tendonitis
- Sensory evaluation
- Therapeutic exercises starting with ROM exercises, and as the patient progresses, adding strengthening exercises
- Ergonomic workstation assessment as needed
- Educating the patient to either avoid or decrease repetitive hand motions, such as pinching, wringing, turning, twisting or grasping
- A home-exercise program
Most cases of De Quervain’s tendonitis settle well with appropriate physiotherapy. The success rate of treatment is largely dictated by patient compliance. Physiotherapy also may be indicated for individuals who have undergone surgical correction at the first dorsal compartment. Once the patient has recovered, the goals of therapy are to strengthen and regain range of motion (ROM) at the thumb, hand, and wrist.
Immediate, appropriate treatment in patients with this condition is essential to ensure a speedy recovery. Once the condition is chronic, healing slows significantly resulting in markedly increased recovery times and an increased likelihood of future recurrence.
If you ever wish to discuss our treatment protocols, or co-management of patients, please do not hesitate to contact this clinic. We would welcome the opportunity to dialogue with you.