Pain Relief for de Quervain’s Syndrome

Physical therapy is a key element in managing de Quervain’s tenosynovitis, offering strategies to reduce inflammation, alleviate pain, and restore wrist and thumb function. With professional guidance from Release PT hand physical therapists, you can find significant symptom relief and return to normal activities.

Does physical therapy work for de Quervain’s tenosynovitis?

Physical therapy helps manage de Quervain’s tenosynovitis, a condition characterized by pain and swelling in the tendons on the thumb side of the wrist. De Quervain’s tenosynovitis physical therapy can reduce inflammation, alleviate pain, and restore function using a range of treatments including exercises to strengthen the muscles and improve your range of motion of the thumb and wrist, and manual therapy techniques to reduce tendon irritation.

We may also advise on ergonomic adjustments to prevent strain on affected tendons during daily activities. With a tailored physical therapy program from Release PT, many of our patients experience significant improvement in their symptoms and return to their normal activities.

What is the best exercise for de Quervain’s tenosynovitis?

For those suffering from de Quervain’s tenosynovitis, incorporating thumb stretch and wrist flex extension exercises can significantly aid in recovery. Determining which physical therapy exercises for de Quervain’s tenosynovitis are best depends on your specific symptoms and recovery goals.

The thumb stretch targets affected tendons alleviating tightness and improving flexibility.  Wrist flexion-extension exercises strengthen and increase your range of motion in the wrist. Combining the two, under the guidance of one of our Release PT physical therapists provides the most comprehensive approach to managing de Quervain’s symptoms.

What movements should be avoided with de Quervain’s?

When managing de Quervain’s tenosynovitis, avoid movements that can exacerbate it by putting additional strain on affected tendons. These include:

• Forceful Gripping or Clenching: Activities that involve a tight grip or forceful clenching of the hand can increase pain and inflammation in the tendons.
• Repetitive Thumb Movements: Actions that require repetitive motion of the thumb, such as typing or gaming, should be minimized.
• Wrist Twisting: Movements that involve twisting the wrist, especially when combined with thumb flexion or extension, can aggravate symptoms.
• Lifting Heavy Objects: Picking up heavy items with the thumb and fingers can put undue stress on the wrist and exacerbate pain.
• Radial Deviation: Movements that bend the wrist towards the thumb (radial deviation) can also worsen discomfort.

Modifying activities to reduce stress on the wrist and thumb, using ergonomic tools, and taking regular breaks during tasks can help manage symptoms. In some cases, we might recommend wearing a splint to immobilize the thumb and wrist can provide relief by limiting aggravating movements.

What is the conservative rehab protocol for de Quervain’s?

The conservative rehab protocol for de Quervain’s tenosynovitis emphasizes:

• Rest: Minimize activities that worsen symptoms to decrease inflammation.
• Splinting: Use a thumb spica splint for immobilization and healing.
• Ice Therapy: Apply ice to lessen swelling and pain.
• NSAIDs: Take medications like ibuprofen for inflammation and pain relief.
• Physical Therapy: Tailored exercises for flexibility and strength
• Activity Modification: Adjust daily habits and workspace ergonomics to avoid aggravating the condition.
• Corticosteroid Injections: Consider injections for persistent symptoms.

Following this protocol under professional guidance can significantly improve symptoms and aid recovery.

Will a wrist brace help de Quervain’s tenosynovitis?

A wrist brace, specifically a thumb spica splint or brace, can help manage de Quervain’s tenosynovitis. This brace immobilizes the thumb and wrist, restricting movements that aggravate the condition, like grasping, pinching, and wringing.

By limiting motion, the brace reduces irritation and inflammation in the tendons, providing pain relief and allowing the affected area to rest and heal. Your Release PT therapist might recommend wearing a wrist brace as part of the initial conservative treatment strategy, especially during activities that could worsen symptoms.

Does de Quervain’s tenosynovitis ever go away?

While de Quervain’s tenosynovitis might not go away completely for everyone, proper management using the right treatment approach, can lead to long-term relief and prevent recurrence. With physical therapy, rest, splinting, and anti-inflammatory medications, the condition frequently improves, and symptoms may substantially decrease or even resolve completely over time. The key to successful management is early diagnosis and appropriate, consistent treatment.

Is ice or heat better for de Quervain’s tenosynovitis?

For de Quervain’s tenosynovitis, we generally recommend ice instead of heat, especially in the initial stages or during flare-ups. Applying ice to the affected area helps reduce inflammation and numb the pain, providing relief. Ice therapy is advised for 15-20 minutes at a time, several times a day, using a cloth barrier to protect the skin.

Heat therapy may be beneficial in later stages of recovery, particularly if the main symptoms are stiffness and muscle tension around the wrist and thumb. Heat can improve blood circulation and relax tight muscles, but use it cautiously to avoid increasing inflammation. Your physical therapist will go over with you which one they recommend for your individual treatment.

How long does it take for de Quervain’s tenosynovitis to go away with physical therapy?

Recovery time for de Quervain’s tenosynovitis varies. Many patients see improvement within weeks of starting conservative treatments like de Quervain’s physical therapy, rest, and splinting. Complete recovery can take several months. Following proper treatment and activity modification is important for healing.

Why is de Quervain’s tenosynovitis so painful?

De Quervain’s tenosynovitis is painful due to inflammation of the synovium, the sheath that surrounds two tendons responsible for thumb movement. This inflammation causes the sheath to thicken and narrow, restricting tendon movement. When the thumb moves, the inflamed tendons rub against the narrowed tunnel, leading to pain and discomfort, especially during gripping or twisting motions.

The pain can be exacerbated by repetitive actions that strain the wrist and thumb, further irritating the affected tendons. The combination of inflammation, restricted tendon movement, and repetitive strain contributes to the significant pain associated with de Quervain’s tenosynovitis.

Where do you massage for de Quervain’s?

Physical therapy for de Quervain’s tendonitis may focus on therapeutic massage and manual therapy techniques on the wrist and the base of the thumb, targeting the area along the tendons affected by the condition. These tendons are located in the first dorsal compartment of the wrist, on the thumb side.

Therapeutic massage aims to reduce inflammation, alleviate pain, and improve mobility by gently manipulating the soft tissues surrounding the tendons. Our therapists may also work on the forearm and the area around the wrist to release tension and improve overall function. We understand that it’s important to have these therapies performed by a physical therapy professional who understands the anatomy involved in de Quervain’s tenosynovitis to ensure the treatment is effective and safe.

Our Release PT hand physical therapists will conduct a detailed assessment of your hand’s function and condition and guide you through specific exercises targeting strength, flexibility, and mobility, managing your condition to improve hand mobility.

There are many different factors that go into healing and rehabilitating de Quervain’s pain. The skilled team at Release PT is ready to help you recover and get back to your normal, active lifestyle. For more information or to book an appointment, feel free to use our online form or give us a call at 202-974-6621.