Recognising and treating Thumb Pain (De Quervain’s Syndrome)
Thumb Pain, or as it is correctly known as, De Quervain’s Syndrome is inflammation of the two tendons that move the thumb, and the sheath they run through. Commonly seen as an R.S.I. injury, the causes can be varied but are mainly due to repeated movements from work, hobbies or lifestyle. Higher risk factors include those over 40 years of age, and females. Pregnancy is also an increased risk factor.
Diagnosis of the De Quervain’s Syndrome is normally obtained from a physical examination including the Finkelstien’s orthopedic test. X-rays or other medical examination may be used to rule out other possibilities such as fracture, arthritis or other casues.
Corticosteroid injection, splinting, rest, ice and NSAID’s are the common methods of treatment, with surgery being a final option.
A friend of mine asked about treatment for her thumb pain and wrist discomfort. As a hairdresser she was never really able to give the arm a rest and the increasing pain in the cutting hand was reaching an unbearable level. Her doctor had recommended surgery.
We began treatments once a week and discovered that pain reduction was quickly achieved, improved movement was restored and quality of life generally was better. Including sleep. The pain would wake her frequently throughout the night.
The only problem was her work. There was little chance of her being able to take a break to allow the wrist and forearm to settle. So we moved the treatments to twice a week, with very good results.
Surgery was avoided.
A wonderful thick French accent filled the room when he spoke. Unbearable pain from his left wrist often woke him up at night. He couldn’t pick anything up in that hand, support weight, or complete small tasks that had been once so easy. Was there anything that could be done?
It turned out that decades of holding a painting palette had taken a toll on that thumb, wrist and forearm. He is a painter, restores artwork and also specialises in gilding, the art of applying gold leaf to objects. We started treatments once a week but after 3 weeks there was little change. With so many years of work contributing to the condition we decided to get an x-ray of the joint to determine how bad things were.
The report wasn’t good.
The thumb joint had degenerated significantly, there was significant arthritis and very little cartilage left. Even with this news we proceeded with treatments, twice a week, just to see if things would change.
Thankfully it didn’t take long.
After all of the years of painting with brushes, he had moved to computers and electronic methods of achieving the same quality work that his clients knew him for. The thumb and forearm were not being used while being treated, and the shift in treatment frequency from once to twice a week brought about a quick change. Sleep improved with the reduction in pain. Small tasks, once impossible, were now easily achieved. Thing were looking good, and it wasn’t long before I was able to say goodbye to the lovely French gentleman and wish him well.
But not before grabbing a business card. I had just found the person to illustrate the channels we needed for the book we were writing.
For more information on other arm/hand related issues go to the RSI, Tennis Elbow and Carpal Tunnel Syndrome blogs.
