What is it?
De Quervain’s Tenosynovitis is compression or irritation of two tendons that run along the wrist and attach to the thumb. This injury is usually caused from overuse and can be debilitating.
The Anatomy
The abductor pollcis longus (APL) and the extensor pollcis brevis (EPB) muscles travel from the forearm and attach at the thumb. These two muscles are primary moves of the thumb. They also cross the wrist joint an, although are not the main movers, will be stretched and contracted as the wrist moves. In addition, the muscles have a sheath that helps protect and allow movement over the bones without additional shearing.
The Damage
When the muscle and tendon sheath become irritated the area below can develop inflammation. This will cause irritants to fill the area which will ultimately increase the pain. This damage is mainly due to overuse but can be from an acute injury to the muscle or tendon. When the wrist and thumb are put in an extended position for prolonged periods of time, the muscles can become irritated.
This is very common in new moms who are carrying their babies. When a mother holds the baby in one arm with a bent wrist the muscles are stressed more than they are prepared. Other instances involve shoveling, constant lifting of heavy objects, and manipulation of objects.
Depending on the severity will determine the course of action for treatment. Many times people will require a splint for a few weeks. This will encourage decreased use and allow time for the inflammation to go down. Once the irritation has decreased strength training can begin to rebuild the muscle fibers and tissue.
Serious issues may require injections and more invasive procedures to help the healing process. It is important to try conservative efforts first before more aggressive treatments. Getting on a structured rehab process and routine to reduce irritation is the best case scenario to help resolve this issue.