Friday, 29 July 2016

How much do you use your thumb? De Quervain's Tenosynovitis

How much do you think you use your thumb? 

Evolutionarily, it's one of the things that's made us humans more advanced than other species. But do you ever think of how much work it does? Maybe not, until it's in pain. Then every time you move your arm, fill the kettle, hold a coffee cup, write with a pen, get dressed or carry a bag -- you realise your thumb is doing a lot of work. 

I've recently had a patient in my clinic with De Quervain's Tenosynovitis -- fancy name for a condition of the tendons running into the thumb. It's not primarily a condition of inflammation, but more of a mechanical change in the tendons and the coverings of those tendons. A tendon is surrounded by a sheath, which helps it glide, move, and reduce friction. 

The cause of this condition is unknown, but it is thought to be linked to overuse of the area (i.e.: texting, mobile phone usage, repetitive use, and occupations that require gripping & twisting with the hand. 

Many believe that this condition is an inflammation of the tendons and their sheaths. However, the pathophysiology is more that of a cellular thickening of those tendons and their sheaths with gradual degenerative changes too.  

This can be a slow condition to completely resolve, but it does respond to osteopathy. It's important to address the biomechanics and altered positioning of the upper limb, any restrictions in the Thoracic and Cervical spines, and myofascial adhesions and trigger points in the forearm muscles. I also use acupuncture (in the Lung Meridian) and RockTape to support the healing. 

As with any condition, using hands-on manual techniques isn't enough. Once the acute pain stage has lessened, it's of utmost importance to to get the patient into a rehabilitative exercise program to prevent the recurrence of the condition. 

If you suffer with pain on the thumb-side of your hand/wrist, have any burning sensations in your hand, muscle spasms, swelling, or difficulty using your hand, have it checked out by your osteopath. 

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