Definition

De Quervain’s tenosynovitis, commonly known as "Mommy's thumb" refers to strain and inflammation of the tendon of the thumb near the wrist. For chronic inflammation cases, the tendon sheath becomes thicker and the space inside the tendon sheath will be narrowed and restricted the gliding inside. Patients may experience pain and a "locking feeling" of the thumb when using it.
Self File | thumbpain physiotherapy De Quervain

 

Causes



Most of the hand functions involve the usage of the thumb. The thumb’s tendons can be easily pulled due to excessive force or incorrect biomechanics (such as the wrong way of holding the baby). In addition, when the thumb abducts or being stretched repeatedly, soft tissue wear and tear happens near the wrist area. The resulting adhesion will cause further compression on the local tendon and make the tendon slide unsmoothly.

Self File | 手指公痛物理治療媽媽手運動1

 

 

Risk Factors

 "Mommy's thumb" is often seen in pregnant women in the late trimester or just after childbirth, especially women who lack physical activity before. They need to hold a baby repetitively with a certain weight and do more housework such as washing clothes and twisting towels.

 

Those who need to use their thumb repeatedly at work are susceptible to this disease, such as computer users, waiters with heavy plates in one hand, hairdressers, gardeners, chefs, etc.

 

 

 

Common Symptoms
  • Weakness or persistent pain over the thumb near the wrist, also more severe when you wake up in the morning
  • With symptoms such as tightness of the upper limbs, local swelling, etc; and it will extend upwards to the forearm and downwards to the thumb fingertip
  • When the wrist and hand are twisted, or the thumb is repeatedly stretched and flexed, the pain will be exacerbated. For example, twisting towels, writing, and other activities that use the thumb with force will be very difficult.
  • If the disease develops, it will cause soft tissue to over-grow, and a prominent mass can be felt on the thumb

 

 

Management

Minimize unnecessary thumb movements in acute inflammation. Using a thumb brace, electrophysical therapy including ice-pad, ultrasound, laser, acupuncture, etc. can help reduce pain and swelling. Deep friction massage techniques can effectively reduce symptoms and maintain soft tissue flexibility. If the pain persists and seriously affects daily activities, you can take non-steroidal anti-inflammatory drugs or local small-dose steroid injections with doctors' prescriptions. When the symptoms gradually ease, more stretching and muscle training should be done to improve muscle strength and flexibility. In the long run, it is necessary to understand the cause of the injury, correct the posture of the thumb usage, and avoid re-injury.

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Preventive Measures

The simplest prevention method is to minimize the usage of thumbs; for example, when holding a child, try to support the child with five fingers or forearm, spread the loading evenly, and avoid the child's weight from being completely supported by the thumb. If you need to use your thumb for a long time at work, the most important thing is to give your thumb more intermittent rest and do some local massage or stretching exercises of the tendon. If necessary, a thumb brace or sports taping can be used to protect the thumb.

 

 

 

 

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