DeQuervain’s Tenosynovitis aka Mommy’s thumb

DeQuervain’s tenosynovitis is inflammation of the tendon sheath that makes up the 1st dorsal compartment of the wrist, usually resulting in thumb side of wrist pain, sometimes along the forearm. There are 6 dorsal compartments at the back of the wrist which the wrist and digit extensor tendons pass through to reach their destinations. The first dorsal compartment houses the Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB) tendons which assist in moving the thumb.


Often overuse of the 1st dorsal compartment and repetitive movement patterns can create inflammation around the tendon. Especially for new mothers who are lifting and picking up their newborns and holding sustained positions for nursing; thus, giving DeQuervain’s the additional nick name “Mommy’s Thumb”.

Other daily activities that can lead to inflammation and DeQuervain’s over time include opening jars, cutting with scissors, playing piano or other instruments, doing needlework and more. Basically, overdoing any activity can cause inflammation and muscle irritation!

Fortunately, there are several treatment options and more often do not require surgical treatment.

  • Rest with application of heat packs or cold packs
  • Corticosteroids and NSAIDs for inflammation
  • Therapeutic ultrasound or infrared light therapy
  • Hand therapy treatment including stretching, soft tissue mobilization, active and passive motion, strengthening once pain is decreased
  • Body mechanics and ergonomics training
  • Custom or prefabricated orthotic devices for immobilization

Surgical Treatment options

  • Steroid injection for pain and inflammation management
  • 1st dorsal compartment release

Great, how does this affect me every day?
Wonderful question, I thought you’d never ask! Addressing tendinitis and tenosynovitis is rooted in the way you have moved for YEARS. You thought this would be an easy answer? Over time the body learns ways to move more quickly, and be lazier resulting in compensatory movement patterns that rely on weaker, smaller muscles. This is why after years and years of moving the same way with no issue, finally your muscles have had enough and are letting you know with pain. Now retraining movement patterns is a conscious effort that will result in less pain, swelling and weakness!

Assess your work station set up. Maybe COVID 19 has resulted in working from home at your kitchen counter or table. Monitor your wrist position.

Instead of reaching for heavy objects, such as a water pitcher or gallon of milk with one hand. Use two! Distribute the weight and force through more muscles.

References:
ch7, pg 509 https://studentconsult.inkling.com/read/skirven-rehabilitation-hand-upper-extremity-7e/chapter-35/stenosing-tendovaginitis
https://www.asht.org/sites/default/files/docs/2018/DeQuervain%202018.pdf

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