| De Quervains Syndrome |
GENERAL
A common condition of inflammation around the tendons on the thumb side of the wrist. Tendons are cord like structures connecting muscles to bone. They pass under a strap of tissue (called a retinaculum) which holds the tendons in place and prevents bowstringing. In effect the tendons pass through a tunnel which is lubricated by the fluid produced by a thin layer of tissue called tenosynovium. When this tissue is inflamed it is called "tenosynovitis". Multiple small branches of the Radial nerve pass through the region at the base of the thumb and are occasionally involved in the inflammation in this region.
CAUSE
Usually highly repetitive movements of the wrist and thumb such as lifting , grasping and twisting. It is very common in mothers with young babies. It may also occur in more generalised conditions such as Diabetes and some types of inflammatory arthritis.
SYMPTOMS
Pain on the thumb side of the wrist. Sometimes there is swelling or a cyst develops. When severe there may be catching or snapping with thumb movement or numbness on the back of the thumb and index finger.
Diagnosis can be aided by this test called finkelteins the manouvre shown will reproduce the pain
TREATMENT
1. Rest.
2. Anti-Inflammatory Tablets e.g. Voltarol (should be taken with food to prevent stomach irritation).
3. Anti-Inflammatory Creams
4. Splints - from physiotherapist.
5. Cortisone Injections - probably the most effective conservative treatment
6. Operation - remove inflamed tissue and release and lengthen the retinaculum so there is more room for the tendons.
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