De Quervain syndrome is a type of tendon injury, which occurs around the muscles that control movement of the thumb. It is also known as gamer’s thumb, washerwoman’s sprain or mummy thumb. This problem is commonly seen in workers who perform repetitive activities such as pinching, grasping, pulling or pulling but current research still has not found any strong evidence of the relationship with occupational contributing factors (Stahl et al., Dec 2013). Although, evidence does state that women are affected more frequently than men, especially during and after pregnancy.
Your physiotherapist or consultant will use Finkelstein’s test to diagnose De Quervain syndrome, which involves grasping your thumb. This will cause a sharp pain along the top of the forearm, just below the wrist.
Another symptom can be swelling around the base of the thumb and wrist. Your consultant may also send you for other investigations such as X-ray, MRI scan or ultrasound to ensure you do not have osteoarthritis, intersection syndrome or Wartenberg’s syndrome, as the symptoms of these can be similar to De Quervain syndrome.
There are various treatments that can be used to manage the symptoms of De Quervain. Medical intervention involves corticosteroid injections, splinting to immobilise the wrist and thumb to the adjacent finger joints for 4-6 weeks, and anti-inflammatory medication such as Ibuprofen and Naproxen. We recommend the Aircast A2 wrist splint and thumb spica Physiotherapy can help by providing you with alternative lifting mechanics to off load as well as activities to avoid exacerbating the inflamed area. They can also perform treatments to reduce inflammation and pain using TENS, dry needling and ice treatment.
If conservative treatment is not successful, surgery will be required whereby the friction causing the inflammation will be addressed to restore the tendon’s smooth gliding capability. After surgery your consultant will recommend for you to see a physiotherapist to provide exercise programme to strengthen your thumb and wrist. If you’re suffering with pain on movement or certain activities using your thumb, get in touch to organise an initial appointment with one of our highly specialised physios today!
More detailed information about De Quervains and how to manage it can be found by clicking here.
Post by Zoe Birch, Head of Orthopaedic Physiotherapy at Physiocomestoyou.