Wrist and thumb pain?

Posted by Alina on Wednesday Nov 26, 2008 Under body mechanics, health

De Quervain’s tenosynovitis is an inflammation of the sheath that surrounds two tendons that control movement of the thumb and/or the inflammation of the tendons themselves. Tendons connect muscles to bones, and in this case, the involved tendons are those of extensor pollicis brevis and abductor pollicis longus muscles, which move the thumb away from the palm in the plane of the palm. De Quervain’s tenosynovitis is often caused by repetitive hand and thumb motions, such as lowering a child or plate, typing on hand held device (aka Blackberry thumb), wringing, and use of a computer mouse. Symptoms include pain on the thumb side of the wrist, possibly spreading further up the forearm and/or to the thumb, swelling, “snapping” sensation when moving thumb, numbness on back of thumb and index finger, and pain with grasping objects with thumb and forefinger. Diagnosis is typically made through a physical examination, specifically the Finkelstein’s test. Treatment often consists of rest, keeping wrist in a neutral position (via use of a thumb spica splint), which allows the affected tendons to rest

Finklestein's Test

Finklestein's Test

and heal. Anti-inflammatory medications may help decrease swelling and reduce pain. Iontophoresis or phonophoresis may also be used. Visiting a physical or occupational therapist who specializes in hand therapy can help speed recovery and provide knowledge of proper body mechanics, useful exercises, and how to avoid injury in the future. If conservative treatment fails, the doctor may inject cortisone to the inflamed site. If nothing else yields results, surgery may be performed to release the roof of the tunnel to give the tendons more space. With conservative treatment, you may feel better in four to eight weeks. After surgery, recovery is more involved and usually takes several months.

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