De Quervain’s tenosynovitis
The tendons that pull the thumb backwards and outwards from the hand run in a sheath as they cross the wrist and with overuse the sheath may become inflamed, known as tenosynovitis. The patient will complain of pain on using the thumb which is important in all hand movements, especially those requiring precision as in writing etc. Holding the thumb across the palm will also produce pain as the tendons are stretched through the inflamed sheath.
Physiotherapy can help by applying a specific massage technique called frictions across the painful area, with advice to modify activities as far as possible to avoid aggravating the condition. Ice and electrotherapy, usually ultrasound, can be used. A thumb brace can splint the thumb to avoid excessive movement but these aren’t always effective and the pressure of the brace against the area can be uncomfortable. An injection of anti-inflammatory steroid into the sheath can cure the condition although more than one injection may be needed to achieve full recovery.
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