Treatment for dequervain's tenosynovitis question I developed dequervain's tenosynovitis (right side) and saw an orthopedic surgeon. He sent me to physical therapy. The pt suggested using a splint for immobilization, and gave me one. The following week
In . In general it is beneficial to protect and rest muscles and tendons that are acutely inflamed and painful. Splinting, taping, ice and oral antiinflammatory agents such as Ibuprofen are helpful. Once the pain has subsided and the joints are stiff, then range of motion and gentle activity is most useful. I guess in a way they are both right. Best wishes.
I . I usually treat dequervain's tenosynovitis with 1) a thumb spica splint that goes up to the end knuckle on the thumb and 2) a cortisone shot. Moving a sore, inflamed, painful tendon right away can make the pain worse. A period of rest is usually the best way to start, then gentle home exercise once the pain goes down. This is also called mommy thumb - you can read more at the link below or just google mommy thumb and you can see an article and a video i wrote about this.
I . I have found that a soft neoprene splint works well for dequervain's tenosynovitis. A soft splint tends to inhibit the thumb and wrist from going toward the extremes of motion ( the position of thumb extension -hitchhiking- and simultaneous radial deviation of the wrist--moving your wrist and hand toward the thumb side and the opposite, turning the wrist away form the thumb side while reaching or pinching with the thumb. ( imagine you are reaching for a bag with your arm extended) rigid splints feel ok when they are on but as soon as they are off often the pain feels worse rigid splints also can irritate the radial sensory nerve and give numbness in the thumb and webspace ( fooling many into being "diagnosed" with carpal tunnel ! finally a rigid splint may just irritate the tendons and the area known as a radial styloid. The problems that occur with a rigid splint often dissuade physicians from recommending them. Or they do as dr. Henley advised in the previous post and use a more comprehensive splint ( this works too) however most splints that one get that are rigid are just over the counter cardboard reinforced radial thumb outriggers that seem to cause more problems than they are worth one other word of caution, many times dequervains is confused with or occurs in conjunction with arthritis of the base of the thumb. Make sure that x-rays have been taken to rule this out. It is especially troublesome to have surgery for tendinitis only to find out that a component of the pain was not related to tendonitis. Finally irritation of the nerve on the thumb side of ones wrist, the radial sensory nerve can also yield pain. So a soft thumb spica the splint, without stays or restraints in it, is what i typically give to someone i see in the office as well as a discussion of the role or anti-inflammatory medication and cortisone injections.