Pain in the thumb? Irradiation towards the forearm? We could be dealing with Quervain’s tendinopathy.
What is Quervain’s tendinopathy?
Quervain’s tendinopathy affects 2 tendons of the 1st finger (thumb) which are the abductor (separator) long and extensor brevis. It consists of the inflammation of these tendons by the presence of liquid in the synovial sheath that surrounds it.
We are talking about an envelope presented by all the tendons of the hand whose objective is to protect them from friction or rubbing with other structures. Therefore, if a trauma, stretching or any other mechanism occurs, fluid is created in these sheaths in order to protect the tendons and causing pain in that area.
If we make an upward and outward movement of our thumb we will see how these two tendons will be more noticeable and will form what is called the anatomical snuffbox (inner area of the wrist, before reaching the thumb).
One of the quick and easy ways to know if we have damage in these tendons is with the Finkelstein Test:
It consists of placing our thumb in the palm of the hand and embrace it with the other fingers. Once in this position we will incline the wrist downwards. It is positive and therefore probable that we have a damage in these structures if when doing this test it hurts in the previously described territory.
Do you know the difference between tendinopathy and tenosynovitis?
When we talk about tendinopathy, we refer to inflammation of the tendon itself, which can lead to poor organization of its fibers.
While a tenosynovitis, apart from the inflammation of the tendon, fluid is produced in the synovial sheath that surrounds the tendon in order to protect it and is the culprit of causing pain.
Why does this pathology occur?
One of the most important causes is the repetition of a movement in daily life, such as writing, in the case of a student, or maintained positions, for example, the use of a mouse in an office.
Another cause may be a direct trauma (especially in athletes) on the tendon area or abrupt gesture (tennis, paddle, golf, etc.) or falls with poor support of the wrist.
Finally, they can also be caused by diseases such as inflammatory arthritis.
What are the predisposing factors to have Quervain’s tendinopathy?
- Age: people between 30 and 50 years of age have a higher risk of suffering from this pathology than other age groups.
- Sex: The condition is more frequent in women.
- Pregnancy: this tendinopathy may be associated with this stage.
How can we treat this pathology?
From the field of physiotherapy we can offer conventional treatment and/or advanced treatment.
Conventional treatment:
It consists of the application of US, laser therapy and magnetic therapy to reduce inflammation and pain. And also Manual Therapy and kinesitherapy, using the first with the aim of relieving tension of the affected musculature and the second to prevent the joint is blocked by the lack of movement.
Advanced treatment:
It consists of the application of invasive techniques such as EPI(Percutaneous Intratissue Electrolysis) and PNM(Percutaneous Neuromodulation).
With EPI what we are looking for is a regeneration of the damaged tissues, in this case, the tendons of the 1st finger of the hand and lower the inflammation of that area.
While with NMP we would work on pain through the nerves that innervate these tendons.
Both techniques are performed with acupuncture needles and always in an ultrasound-guided manner to see where we introduce the needle.
We could also work on this type of treatment with INDIBA. A diathermy machine that we use to help lower inflammation and normalize the altered musculature.
Medical Therapy:
In the event that these treatments are not sufficient or the extent of the injury is very serious, it is possible to perform a TM(Medical Therapy).
It would consist of an infiltration with corticoids in the damaged tendons that in a matter of hours would lower the inflammation of the injured area and in 24 hours we would be talking about a considerable improvement of the pain.
These 3 types of treatments are fully compatible with each other and it is recommended, since in this way the patient’s recovery would be much faster and effective.
In our MIVI center we have all the necessary equipment to perform these treatments, helping in the recovery and quality of life.