dequervains tenosynovitus

[rosi69]

I was diagnosed with Dequervains Tenosynovitis in February 2008. I was treated by a hand specialist with a cortisone shut, and prescribed a Thumb Spica splint. This treatment resolved my problem. No,  February 2009 and I am having the same issue and pain in the same wrist. Should I treat myself with icing my wrist and wearing the Spica splint? OR should I go back to the Hand specialist. I am in pain.


This discussion is related to de quervain tenosynovitis.

[neckandshoulders]

I am trying to post my comments as it relates to my experience with de Quervain, especially when in comes to surgery as a considered option. Hope this helps:

I have glanced through most forums, blogs, etc. on de Quervain and may have a few useful aspects to share. I waited to publish anything because I wanted to test everything and give it time to prove success. I have had phenomenal success with mainly some simple exercises and stretches and am functioning pretty much as I had before the onset. I will not label my success as a cure because I know this condition can come and go, but will provide updates if my path changes again. I feel a bit of background is important in case you find other insights or ideas.

I was diagnosed with de Quervain symptoms in both wrists since the summer of 2009 and had some really bad bouts of pain, burning, waking with aches, tingling in the index finger, etc. during 2009 and the summer of 2010. I immediately ran to the orthopedic clinic and was almost forced to consider surgery. I ran! It came on very sudden after a long car trip, in which I tend to extend and push my thumb on the top of the steering wheel. I also tend to push on my thumb and pinkie in locked extended position with the use of a turbo mouse. The pain got so bad I thought I was going to have to give up my work in graphic design. I have tried everything except surgery. I did one Cortizone shot and it abated the pain for about 2-3 months. Hand massage and stretching helped a little. Took some meds, mainly for the inflammation, but was not interested in masking the pain. Did a few ultrasound and infrared sessions, felt cool, but worked like the massage. Chiropractic treatments seem to be doing something, but did not take the pain away completely. Focused heavily on posture, ergonomics at work, changing habits, rest, etc. Had two free deep massage sessions on my neck on shoulders and felt great for a few days. I had full spectrum blood/systemic tests and checked for deficiencies (was a bit low in B-12 and docs asked about my diet which did not include a lot of animal protein). I looked into prolotherapy, PRP injections and acupuncture, but did not commit. Even inquired about neuromodulation, but figured I would never be a good candidate. Tried lots of different types of exercise and usually felt pretty good during a good cardio workout, probably because of good blood flow. Copied a slow hand-weight regimen I saw on YouTube. Tired my own set of isometric weight exercises (5-10 lbs. at the most), didn't help or add to the pain, interestingly. Tired 3 different types of mouse and keyboard set-ups. Bracing, tape, splints, immobilization, etc. was fine until I took off the brace off, I even tested a prototype cast from Exos Medical (I mentioned this company because I spoke briefly with their sports physiologist who told me something important that stuck in the back of my mind and will get to further in). I searched and searched for more information and never found anything useful and most was not very positive. I assume those who have found relief do not share their results for whatever reason, but I am driven to provide some insight since I know the feeling when you don't know where to turn.

In the winter of 2011 I recalled my conversation with the Exos sports physiologist, the chiropractor and the deep massage sessions. I was too focused on just my wrists, fingers and forearm and really had not tried anything in the upper body and neck. I started some simple slow motion neck movements and stretching in the shoulders, neck and arms. I am not saying this is a cure, but I have been almost pain-free, without inflammation, etc. since the early spring 2011. One hypothesis is that the condition, whether de Quervain or not, is being created by a combination of the subluxation that I have in the extremity joints and the involvement of nerves that emanate from the lower cervical (neck) region also as it all ties together with the muscles in the upper body. Whenever I take a shower I do some very simple stretches and movements and focus on my neck, upper shoulders, back, forearm and a bit on the fingers and wrists. If interested, I can try to explain the mechanics in a future post. I did not try any more upper body deep massage, but that may help and certainly can not hurt. The only other things, to which my success can be attributed, would be the additions of a complex B vitamin and more protein. I also do not try to lock my thumb in a stretched position for any long periods. There is nothing else I have changed in my lifestyle, diet, etc. And I'm sure my posture has gone back to its bad habits. The only time I feel a tinge of the pain is when under stress or have forgotten to do my stretching for a couple days or have not exercised. Otherwise the only feeling I have is some stiffness.

I do have a couple strong opinion. First, do not jump to surgery, you are your own advocate for your health and you owe it to yourself to consider all the options and test a few things. Even if you have gone through surgery and have not had complete success you can still try other options. Surgery may work and may be the end option, but found only a handful of physicians who would consider other treatments or would offer up information of success stories. Second, rest is not the answer in my case, the only time I got relief was when I was aggressively using my hand, thumb, the muscles, etc. The sports physiologist said he had seen many cases of de Quervain and nobody ever did more damage when pushing hard during exercise or doing tasks that involved grasping, pushing, etc.. A lot of his athletes would, as he put it: "stretch the hell out of those muscles and work your back and upper body as hard as you can."

I hope this provides some hope and ideas to try. I would be happy to provide more detail and hear more thoughts.

[txsilver]

Great insight, dai3symae!  Thank you for sharing your experience with this condition.  

rosi69, I do hope you will let us know what you decide to do and how it works out for you.

[dai3symae]

I was dx'd Dequervains Tenosynovitis about 7 yrs ago.  For a while the cortisone shots and anti inflammatories kept the pain at a tolerable level.  I wore a wrist splint...and often slept in it a night.  Eventually that wasn't enough to control the pain.

I had tendon release surgery about 6 yrs ago.  I have not had pain since.  The recovery time was only a few weeks.

You should definately go back to your doctor.  I suffered muscle atrophy in my arm because I waited so long to seek treatment.

[Telgirl_71]

I have had this since June, I am sick of the pain, doc diagnosed and said it was chronic from the scan I had, I just wanted the operation as I also have very busy work load. Doc refused surgery and said I had to have all these different injections, and hand splint but won't prescribe hand splint because it is too dear, I am sick of it all

[txsilver]

Do you have anything you can take or do to relieve the pain?  If not, I would go in just to get relief from the pain.  If you have a way to reduce/alleviate the pain, you might try the ice and splint if you really do not want to go to the doctor but, if it does not improve in a few days, you should definitely get back in to see the doc.