De Quervain syndrome

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De Quervain syndrome is a tendonitis with a strong and early tendency to become chronic, which affects the wrist with a swelling on the radial side extending on the dorsal side of the thumb exactly on the tendons of the muscles extensor brevis and abductor longus of the thumb. With painful and debilitating consequences, De Quervain syndrome often requires a surgical solution. Often, it affects women during the first postpartum period and during breastfeeding.

Symptoms

The main symptom of De Quervain syndrome is the pain especially felt when patients use their thumbs in extension or during grip movements, accompanied by swelling of the tendons from the side of the thumb to the level of the wrist.

If the disease persists, the inflammatory process leads to fibrosis of these tendons resulting in deformation. The development of the syndrome can trigger thumb burst.

Causes

The causes of De Quervain syndrome are:

individual predisposition,
repetitive activities involving the flexion-extension movement of the thumb and hand (sewing, computer work)
functional overloads
nutritional factors due to pregnancy and lactation,
hyper-stress and excessive and prolonged use of new mother’s arm during the first period of child’s life, due to the fact that the newborn is held in her arms.

Diagnosis

On the radial side of the wrist there will be pain, swelling, edema and tenderness to palpation and movement of the wrist and thumb.

The Finkelstein test is often performed for diagnosis. The force of gripping movements is reduced due to pain. The diagnosis is mainly clinical, that is based on the patient’s story and the visual inspection of the part. Wrist radiograph can be useful to rule out other possible causes of pain, such as arthrosis or scaphoid fracture. Ultrasound can also be used to visualize the tendon.

Cures and remedies

The classic treatment of De Quervain syndrome is characterized by functional rest, ice, local anti-inflammatories to reduce pain and inflammation. Some specialists prefer to prescribe a thumb brace to reduce movement.

Physiotherapy aims to reduce inflammation and pain. In some very painful cases, local infiltrations of cortisone and anesthetic are used for rapid relief of symptoms. But care must be taken not to repeat these doses frequently because steroids can promote tendon fibrosis and worsen the condition in medium term. Remind that the eventual disappearance of pain does not indicate the outcome from De Quervain syndrome, but only a first step of relief to which the targeted treatment must follow. Surgery is considered a second choice treatment.

In the case of tendinitis with degeneration, tendinosis, it is essential to use deep nerve stimulation (DNS) and neuromodulation, a particular electric current that manages to restore correct nerve transmission. We are convinced that tendon irritation involves the surrounding nerve and that the latter becomes responsible for the syndrome.

We believe that the intervention of Nervenia is very useful in the case of De Quervain syndrome developed during pregnancy and breastfeeding. Furthermore, in this particular period of a woman’s life, it is not possible to take pain medication because it could interfere with breastfeeding. The treatment of Nervenia has no contraindication and does not use drugs of any kind.