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Is surgery successful for De Quiervain's
One doctor diagnosed my fiance with "De Quervain's tenosynovitis" and another confirmed it. Both doctors have recommended surgery... I am afraid of possible complications and results of this surgery :( Could you please lighten me up a bit? Thanks.
I am trying to post my story on any site, blog, etc. related to de Quervain with hope to share some insights, especially when it comes to surgery:
I waited to share anything because I wanted to test everything and give it time to prove success having chosen to avoid surgery. 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 in the other direction! 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.
I waited to share anything because I wanted to test everything and give it time to prove success having chosen to avoid surgery. 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 in the other direction! 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.
MEDICAL PROFESSIONAL
Do not come to the conclusion or diagnosis before you let your right wrist examined near an orthopaedician. If you have to go for a surgery and want early recovery go for the surgery of the wrist.
Rest of the problems like Rotator cuff and bursitis can be dealt later. Discuss all of these with the orthopaedician so you will take preventive actions and measures not to increase your Rotator cuff problem.
The main concern here is if you postpone the repair then you may injure it more so getting assessed all the problems and knowing the pros and cons for the future is good to take a right course. If you can have an elective surgery later for the Rotator cuff on the advise of the orthopaedician then it is fine!
If your repair of all the problems take place perfectly now then you would be healthy afterwards to take care of your children then it is your call.
Take care!
Rest of the problems like Rotator cuff and bursitis can be dealt later. Discuss all of these with the orthopaedician so you will take preventive actions and measures not to increase your Rotator cuff problem.
The main concern here is if you postpone the repair then you may injure it more so getting assessed all the problems and knowing the pros and cons for the future is good to take a right course. If you can have an elective surgery later for the Rotator cuff on the advise of the orthopaedician then it is fine!
If your repair of all the problems take place perfectly now then you would be healthy afterwards to take care of your children then it is your call.
Take care!
I had this surgery on my left wrist about 6 years ago. Was surprised to see such a small incision, yet had no pain free use of left hand for a bit.
Now I'm a Nurse and as of a week ago suddenly my right wrist/thumb have the exact same symptoms.
I've tried wearing ace wrap, splint but the problem is how these items get in the way of my patient interactions.
Also upon certain twist of the wrist ie: turning a key on a door lock...........I feel the tendon click and getting hung up w/tremendous pain before it releases.
For me, I am pretty certain surgery is the quickest relief in order to get me back to work.
I'm debating on another problem I also have had with my right shoulder.....rotator cuff/bursitis issues -- and that is do I dare just get everything fixed and be layed up longer or just get the wrist repaired ??
I'm trying not to be out of work any longer than necessary and have 4 children under age 10 also.
Decisions, decisions!!
good luck to you,
midgeypoo
Now I'm a Nurse and as of a week ago suddenly my right wrist/thumb have the exact same symptoms.
I've tried wearing ace wrap, splint but the problem is how these items get in the way of my patient interactions.
Also upon certain twist of the wrist ie: turning a key on a door lock...........I feel the tendon click and getting hung up w/tremendous pain before it releases.
For me, I am pretty certain surgery is the quickest relief in order to get me back to work.
I'm debating on another problem I also have had with my right shoulder.....rotator cuff/bursitis issues -- and that is do I dare just get everything fixed and be layed up longer or just get the wrist repaired ??
I'm trying not to be out of work any longer than necessary and have 4 children under age 10 also.
Decisions, decisions!!
good luck to you,
midgeypoo
MEDICAL PROFESSIONAL
de Quervain syndrome (also known as washerwoman's sprain, or mother's wrist), is an inflammation or a tendinosis of the sheath or tunnel that surrounds two tendons that control movement of the thumb.
As the medical treatment is very long term and demotivating the surgeon advised for surgery. Here: sheath of the first dorsal compartment is opened longitudinally and the pain relieved and after good recovery and therapy time it will take 4 weeks normally. But the Orthopaedician would be the best person to tell about it. Take care!
As the medical treatment is very long term and demotivating the surgeon advised for surgery. Here: sheath of the first dorsal compartment is opened longitudinally and the pain relieved and after good recovery and therapy time it will take 4 weeks normally. But the Orthopaedician would be the best person to tell about it. Take care!
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