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De Quervains Tenosynovitis

Overview

APL (Abductor Hallucis Longus) and EHB (Extensor Pollicis Brevis) are the two long muscle tendons from forearm that control the movement of the thumb. These tendons help pull the thumb up and also to stretch it sideways. These tendons are held in place by the band which is just proximal ( above) to the wrist at the base of the thumb. If the band is tighter than necessary, it restricts the movements of the thumb and causes pain. 

Why does De Quervains Tenosynovitis happen?

 

As the tendon has to pass under the band of tissue around the wrist area, the tendons can get thickened and also the band above can become more stiff. 

 

Who gets De Quervains Tenosynovitis?

De Quervains Tenosynovitis is more common in diabetics, patients with hypothyroidism, musicians, keyboard users. Pregnant women during pregnancy or post delivery are likely to get  De Quervains tenosynovitis due to the hormonal changes and weight changes. 

Symptoms

  • Pain on lifting the objects

  • Thumb base pain

  • Wrist pain 

  • Pain with stiffness in movement of thumb and wrist

When to seek medical help?

Clinical assessment is sufficient to diagnose this condition. X-ray are un-necessary. Pain relieving medicines will have temporary relief. 

​What happens when I visit the Consultant?

You will be asked about the nature of injury, symptoms further to that so far. Consultant will examine you and discuss the treatment modalities. In majority of cases, MRI scan wouldn’t be required in the initial assessment. The consultant may ask you to go undergo blood tests to check for the blood sugar levels and thyroid hormone levels.  

What are the Treatment Options?

The De Quervains tenosynovitis treatment modalities range from under warm water exercises to an injection to De Quervains release surgery depending upon the nature of symptoms and duration.

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