1. What is causing the pain and how did I get it?
De Quervain’s tenosynovitis is a painful condition of the wrist caused by inflammation or thickening of the two tendon sheaths that raise the thumb. Inflammation is usually aggravated by repetitive thumb movements and twisting motions of the wrist, causing the tendons of the thumb to “rub” against their surrounding sheaths. Symptoms may include pain, tenderness and swelling over the wrist and base of the thumb area. Pain may be felt during gripping and pinching. It may be hard and painful to move your thumb, particularly when pinching or grasping things. Some people also have swelling and pain on the side of the wrist at the base of the thumb. The pain may get worse when you move your thumb or wrist.
The condition can happen gradually or suddenly. In either case, the pain may travel into the thumb or up the forearm. The condition can cause by repetitive use of thumb and wrist or trauma
2. How can hand occupational therapist help?
A thumb spica splint may be needed to prevent movements at the wrist and thumb, allowing for rest and pain relief. It is to prevent you to overuse the thumb and wrist..
b) Activity modification
Activity modification can help to prevent or minimize symptoms at home and at work. Here are a few methods you can adopt in your daily activities.
- Proper ergonomics : Keep your wrist straight when lifting loads/carrying a child, during typing tasks and when using the mouse. Use tools with bigger grips/handles.
- Minimizing repetition : Avoid prolonged repetitive thumb movements such as texting on mobile phones, using touch screen appliances and hand-held gaming devices over extended periods of time.
- Pacing your activities : Give your hands a break by resting in between tasks. Alternate between light work and hard work requiring You may do this by alternating between easy and hard tasks, switch hands or, if possible, to rotate work activities that require twisting, pinching and lifting actions
- Reduce force and speed Use of appropriate power tools instead of manual tools (eg. electric screwdriver or nail gun).
Your Occupational Therapist will prescribe an exercise program to exercise your thumb and wrist when the pain has gone down. Consult your Occupational Therapist before commencing the exercises.
3. How can we help?
You can ice the area to reduce inflammation after therapist assessment if it is during acute stages of the condition. After the initial acute stage, use of hot packs can also help in reducing stiffness and pain. Complete the exercises as recommended by your Occupational Therapist. Perform them slowly and according to the prescribed frequency by the Occupational Therapist.
4. How long will it take to recover? (ie prognosis)
Recovery times vary depending on your age, general health, and how long you’ve had the symptoms. If your disease has developed gradually, it’s often tougher to treat. So it may take you longer to get relief. If your symptoms are severe or persist after trying non-surgical therapy, surgery may be the most appropriate option.