De Quervains Tenosynovitis Information

De Quervains Tenosynovitis Information

De Quervains tenosynovitis also called a washerwoman's sprain, de Quervain disease, radial styloid tenosynovitis, de Quervains tenosynovitis, or de Quervains stenosing tenosynovitis. Each name describes a tendinosis (damage to a tendon at a cellular level) to the tunnel or sheath surrounding the two thumb tendons. Middle-aged women between the ages of thirty to fifty are most often affected.

 

 

 

 

 

 

De Quervains Tenosynovitis

Anatomy As It Relates To De Quervains Tenosynovitis

The extensor pollicis brevis muscle and abductor pollicis longus muscles run side by side in the forearm. The two tendons from these two muscles pass through a tunnel (the extensor retinaculum) in the wrist on their way to the thumb. This fibrous tunnel simply holds all the tendons passing through the wrist in place as they enter the hand. Slippery synovial sheaths are what allow the tendons to easily glide within their tunnel. The extensor pollicis brevis and abductor pollicis longus tendons are responsible for extending the thumb backwards (radial abduction) and away from the palm of the hand (palmar abduction)

The extensor pollicis brevis and the abductor pollicis longus tendons usually easily glide backwards and forwards in their tunnel as they produce palmar abduction and radial abduction movements. The extensor retinaculum isn’t elastic. So, it can not make room for the tendons when they are swollen, thereby causing the tendons to compress against each other and produce restricted or painful thumb movements.

What Is De Quervains Tenosynovitis?

De Quervains Tenosynovitis is inflammation of the extensor pollicis brevis and the abductor pollicis longus tendons that run along the side of the wrist and base of the thumb. The synovial sheaths may also be inflamed.

What Causes De Quervains Tenosynovitis?

While there is often controversy over whether de Quervains Tenosynovitis should be classified as a repetitive movement injury or not, most clinical case findings are consistent with a chronic degenerative process. The degenerative process is the result of activities that have relied on repetitive hand and wrist movements, such as:

* gardening
* lifting a baby
* wringing out clothes
* carpentry work
* computer work
* playing certain musical instruments
* texting (often referred to as Blackberry thumb)

De Quervains Tenosynovitis may also be caused by a direct traumatic blow to the thumb area. Certain inflammatory conditions, such as inflammatory arthritis, are also thought to trigger de Quervains Tenosynovitis

What Are The Symptoms Of De Quervains Tenosynovitis

* inflammation of the extensor pollicis brevis and the abductor pollicis longus tendons along the side of the wrist and base of the thumb
* localized pain and tenderness
* localized redness may also be present
* pain may occur suddenly in a traumatic injury or more gradually with an overuse injury
* pain may travel from the thumb and wrist area to the forearm in severe cases
* discomfort when the wrist is turned, a fist is made, the thumb is used in a pinching motion, or the thumb and wrist are used to grasp something
* the above motions may also be difficult to perform
* a sensation that the thumb is “sticking” during movement may be felt upon thumb and wrist movement
* an audible squeaking may be heard upon thumb and wrist movement

 

Strengthening Exercises

These Wrist Exercises are ideal to build strength and flexibility.

Massage Treatment

These Wrist Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.

 

ACUTE STAGE SYMPTOMS AND TREATMENT

 

This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.

 

ACUTE STAGE SYMPTOMS:

 

The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the hand because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured hand, causing pain, inflammation, lumps and swelling.

The sensation of heat is due to the warming action of the blood and fluids overheating in the injured hand as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.

As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.

During the acute stage it is very important to restore normal circulation to the hand, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the hand, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the hand can strengthen and regain it's mobility.

 

ACUTE STAGE TREATMENT:

 

1. Apply the Sinew Herbal Ice on your hand to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the hand. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.

Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that donít heal well.

2. Massage your hand with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.

 

 

CHRONIC STAGE SYMPTOMS AND TREATMENT

 

This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.


CHRONIC STAGE SYMPTOMS:

 

The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your hand that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.

Your hand may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your hand you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.

Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.

During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the hand, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.


CHRONIC STAGE TREATMENT:

 

1. Massage your hand with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. The Sinew Relaxing Soak can be used in-between applications.

2. Soak your hand with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. The Sinew Relaxing Soak is particularly useful if you feel restricted mobility in your hand. Chronic Sinew Liniment can be used in-between applications.

3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.