Your thumb and wrist tendons typically travel smoothly in tunnels of tissue known as sheaths, preventing any pain from movement. But when they become irritated and thickened, certain motions could trigger pain in either thumb or wrist.
There are various treatments that may help alleviate your symptoms. This article covers exercises, stretches and techniques which could potentially alleviate pain relief.
What is De Quervain’s synovitis
De Quervain’s tenosynovitis is a condition that involves inflammation of the tendons and their protective sheath in the wrist near the base of the thumb. This inflammation affects the tendons of the abductor pollicis longus and extensor pollicis brevis muscles, which are responsible for moving the thumb away from the palm and extending it.
People with De Quervain’s tenosynovitis typically experience pain, swelling, and tenderness at the base of the thumb or on the side of the wrist. The pain may worsen with thumb and wrist movements, particularly activities that involve grasping, pinching, or twisting motions. Repetitive actions, such as lifting heavy objects or using tools that require a strong grip, can contribute to the development of this condition.
The exact cause of De Quervain’s tenosynovitis is not always clear, but it is often associated with overuse or repetitive strain injuries. Other factors that may contribute to its development include trauma to the wrist or thumb, hormonal changes (such as during pregnancy), and certain inflammatory conditions.
Treatment for De Quervain’s tenosynovitis usually involves resting the affected hand, avoiding activities that exacerbate symptoms, applying ice packs to reduce inflammation, and taking nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and swelling. Wearing a splint or brace to immobilize the thumb and wrist may also be recommended. In some cases, corticosteroid injections may be administered to reduce inflammation and alleviate symptoms. If conservative measures fail to provide relief, surgical intervention to release the constricted tendon sheath may be considered. Early diagnosis and appropriate treatment are essential for managing symptoms and preventing complications.
Finkelstein’s Test
De Quervain’s Syndrome is a painful, snapping sensation in the thumb side of the wrist that’s typically associated with forceful thumb abduction and ulnar deviation activities such as chopping or grasping heavy objects, repetitive or awkward postures used for sports or manual labor, or forceful or prolonged abduction and ulnar deviation resulting from activities like chopping. Other triggers could include forceful or prolonged abduction and ulnar deviation, repetitive or awkward postures used during sports or manual labor activities or repetitive or awkward postures used during sports or manual labor activities resulting in tenderness around the first dorsal compartment of extensor retinaculum which contains Abductor Pollicis Brevis and Extensor Pollicis Longus tendon; typically this symptom can be diagnosed using what’s known as “Finkelstein’s test” by its creator, Dr. Harry Finkelstein himself.
Finkelstein’s test requires healthcare providers to ask patients to tuck their thumb against their palm, wrap their fingers around it, and form a closed fist with their palm facing the little finger’s side. When this motion occurs passively deviating their wrist towards that side’s little finger side it isolates tendons affected by De Quervain’s Synovitis; if pain over the radial styloid occurs during testing then their diagnosis will be confirmed.
Finkelstein’s test is widely recognized as the go-to test for diagnosing de Quervain’s tenosynovitis, providing a clear and concise assessment of affected tendons without using costly imaging technologies like MRI. Furthermore, this reliable and practical diagnostic technique can be performed by most health care providers.
Healthcare providers must understand how to correctly apply and interpret Finkelstein’s test for accurate testing results, otherwise misdiagnosis and unnecessary treatments that prolong symptoms may result. To assist them, healthcare professionals can utilize an online Finkelstein Test Template which offers a standardized format ensuring consistent assessment across settings.
This downloadable template offers step-by-step guidance for conducting the test and highlights important considerations when interpreting its results. Furthermore, the template is free-of-charge making it accessible to a range of healthcare providers.
Thumb-to-Little-Finger Stretch
De Quervain’s Tenosynovitis can usually be easily diagnosed and treated. Your physician will examine both hands and wrists, feel for tender areas, and perform Finkelstein’s Maneuver to stretch tendons on the thumb side of the wrist via Extensor Carpi Radialis Tendon Sheath – if this test causes pain on that side then De Quervain’s Tenosynovitis may have developed.
Your doctor may order X-rays or other tests to rule out other conditions that could produce similar symptoms, and medications, including OTC pain relievers such as Ibuprofen. A corticosteroid injection into the tendon sheath could also provide anti-inflammatory relief.
If your pain continues, physical therapy or occupational therapy could be recommended as an avenue of treatment. Stretches and exercises could be administered to increase mobility of affected tendons through stretching. Some exercises such as moving your thumb away from fingers and palm independently while bending wrist forward and backward may initially cause pain; however, by being patient and following directions carefully from a physical therapist they should become easier over time.
Exercise programs for sitting are typically done while sitting, either at home or the office, though some exercises may require equipment such as light hand weights, resistance bands, squeezable balls or pieces of putty. Exercise slowly and carefully with no push past any point that causes discomfort – any activity which becomes painful should immediately cease.
De Quervain’s Tenosynovitis occurs when two tendons located on the thumb side of your wrist become overused or irritated, causing friction between them and their sheaths, leading to pain, swelling and clicking when trying to bend your thumb or move your wrist forwards and backwards. Physical therapy or occupational therapy exercises have been proven effective at relieving symptoms faster while speeding healing time; be sure to complete them as instructed. Ideally, beginning these exercises as soon as you notice thumb pain is best!
Wrist-to-Little-Finger Stretch
Your doctor will likely ask you to make a fist and bend the wrist down toward your little finger for an exam, and if this movement hurts on the thumb side, this could be a telltale sign of de Quervain’s synovitis. Additionally, imaging tests such as X-rays could also be conducted to confirm diagnosis.
Multiple factors can contribute to this condition, including repetitive activities that involve gripping and twisting the hand and wrist – such as shaking someone’s hand repeatedly or holding on tightly for extended periods.
The problem lies with your thumb tendons and tendon sheaths that run along its backside, which connect muscles in your thumb and palm to your wrist bone via strong, flexible tissue cords called tendons – strong but flexible cords of strong yet flexible tissue that move bones when contracted (squeezed). Tendons in your wrist are protected by sheaths made of smooth fluid called synovium that act like tunnels through which these cords of strong yet flexible tissue move their bones when contracted (squeezed).
Under this condition, your thumb tendons become inflamed and irritated, leading to pain, tenderness, numbness in both thumb and wrist areas.
There are various exercises you can perform to manage this condition, with physical therapy serving as a great guide. Stretching and strengthening exercises may also be appropriate; light hand weights, resistance bands or even squeezable balls may assist.
Start these exercises gradually and don’t exceed your limits when starting these exercises. If any cause discomfort, stop immediately and inform your physical therapist of any discomfort experienced. In addition to exercises, you could try icing your wrist and hand to reduce inflammation and improve blood flow to the area, taking over-the-counter pain relievers as needed, or seeing your doctor about steroid injections into affected areas which may help decrease swelling; all these measures should help relieve symptoms so you can return to daily activities more comfortably.
Wrist-to-Little-Finger Extension
De Quervain’s Tenosynovitis (or De Quervain’s Tenosynovitis) is an injury to the tendons and tendon sheaths that move your thumb, normally moving with ease through tight spaces such as joints. When overuse causes friction between them and friction-sensitive sheaths, swelling occurs that can cause pain, tenderness and even an audible snapping sound when moving the wrist or thumb. This condition often results in discomfort for overworked tendons causing overuse damage which leads to overstretch and inflammation which causes painful tenderness when moving them in these tight spaces causing pain as they attempt to pass smoothly through these tight spaces – sometimes with resultant effects such as clicking noises being heard when moving joints or thumb.
Your healthcare provider will use a physical exam and various tests to diagnose de Quervain’s Tenosynovitis. The most prevalent symptom is wrist pain on the thumb side that worsens with grasping or lifting objects; sometimes this discomfort even travels up your arm. X-rays can help rule out other causes for wrist discomfort such as osteoarthritis.
de Quervain’s Tenosynovitis can be avoided by changing how you approach activities that put stress on your wrist, such as changing tool grip size or taking frequent breaks during working or playing sports activities, wearing wrist supports or splints, wearing wrist braces or receiving injections of steroids or anesthetic into the sheath of your arm. Your provider might also suggest pain medications or injections of steroids or anesthetic directly into the sheath itself.
As well as limiting repetitive movements, certain exercises for de Quervain’s synovitis may include stretching exercises that increase thumb flexibility while strengthening supporting muscles in your hand and wrist. Speak to a physical therapist about which ones would best benefit you.
This exercise aims to stretch and improve flexibility of the thumb tendons. Sitting with hands on table, extend thumb outward so it touches pinkie finger for 2-3 seconds then return it back in. Repeat 10-15 times in 3 sets until there are no longer any discomfort sensations; otherwise consult with therapist.
Put a ball or other squeezable object in your palm and use it to gently push your thumb across the base of your little finger towards your pinkie finger – this will increase flexibility in the tendons and sheath surrounding your thumb tendons and sheath, helping them become more flexible over time. Do this exercise with light pressure for 10-15 seconds until you feel any stretch.
