Repetitive Strain Injuries-DeQuervain’s Tendonitis

Repetitive Strain Injuries-DeQuervain’s Tendonitis

For many years I have treated thousands of patients with debilitating hand pain.  One of the most painful and debilitating conditions I’ve treated is known as DeQuervain’s tendonitis.  It is also commonly known as DeQuervain’s tenonsynovitis.  This life altering condition occurs when there has been significant repetitive strain or continuous stress to the muscles, tendons and joints involving the thumb and thumb side of the wrist.  Eventually this stress will cause the tendons connecting to the thumb to become constricted and inflamed.

DeQuervain’s symptoms include pain on the thumb side of the wrist which can run up into the forearm or even down into the thumb itself.  The pain generally starts off mild becoming more severe if the repetitive stress or strenuous activities continue.  The pain will be worsened by motions such as gripping, making a fist, twisting, or moving the wrist in certain positions.

One of the most common groups of people that suffer from DeQuervain’s tendonitis is new mothers. When a new mother cradles her baby closely and snug to her body she will usually bend one of her hands into a contorted position that compromises the joints and tendons on the thumb side of the wrist.  As she holds her baby for hours on end day after day the muscles and tendons become fatigued in the wrist and hand.  This weakening causes the small carpal bones and hand bones to become misaligned.  When this happens the bones and joints in the wrist/hand complex become restricted in motion causing stiffness and more weakness.  As the mother continues to cradle her baby in this manner the condition becomes worse until eventually the affected tendons become inflamed.

Many times patients will develop a small fluid filled ganglion cyst where a tendon rubs over a pointed bone on the thumb side of the wrist.  This ganglion cyst may be painful and tender to the touch.  This is a sign that the condition has been present for a significant amount of time or the stress on the wrist has been excessive.

The good news is that DeQuervain’s can be treated successfully without the use of medication or surgery.  Another common treatment is for the patient to wear a wrist splint or brace.  Although this will limit the movement of the wrist and maybe give some temporary relief it will not address the underlying problem that causes DeQuervain’s.   To effectively treat this condition I always looked for the cause of the problem in the first place.  First of all I would teach the patient how to hold her baby without causing strain on the side of the wrist allowing her to continue with taking care of her baby’s needs.  Then I would diagnose which bones had become misaligned from the awkward position and stress to the wrist.  Using very specific and gentle joint manipulation to the wrist and hand bones we were able to improve the function, motion and strength of the joints, muscles and inflamed tendons.  After the stress was been removed, the body would naturally allow the tendons to heal and the pain symptoms to resolve.  Once the condition was improved the patient would be shown and taught specific exercises to improve strength and stability in the involved area.

The bad news is that there are not many chiropractors who specialize in treating DeQuervain’s tendonitis.  That’s why I am currently teaching chiropractors the necessary techniques so they can help the most severe hand and wrist conditions.