De Quervain Tenosynovitis (DQT) - the repetitive friction of tendon sheaths due to overuse of Abductor Pollicis Longus(APL) and Extensor Pollicis Brevis (EPB) , lead to swelling & thickening of the extensor retinaculum in the first dorsal compartment, narrowing the fibro-osseous tunnel.
This affects the thumb abductors and extensors which results in pain in the wrist region. Pain & swelling may make it difficult for the thumb & wrist to move or work by irritating the nerve lying on the top of the tendon sheath which may cause numbness on the thumb & index finger. Such a condition arises in situations when the thumb is overused while gaming, texting and it is significantly observed in breastfeeding mothers.
Before catering to the solution of DQT, we need to understand the symptoms that may resonate with most of us reading the article. This may be signified by various warning signs such as pain, tenderness, swelling, burning and weakness generally described as a “constant aching, burning, pulling sensation”. In severe cases, loss of normal sensation, restriction in range of motion and lack of grip strength is observed.
FACT CHECK!! According to the studies, it has been suggested that this condition affects women upto 6 times more often than men.
Mechanism of Injury Contributing to Thumb Pain
DQT mostly occurs due to repetitive motions in the wrist, especially the thumb extension in combination with wrist flexion, ulnar deviation and repetitive gripping. Stress is greatest when ulnar deviation of the wrist is combined with a gripping motion of the thumb. People who use their thumb in repetitive pinching, extension activities of the wrist and hand like use of mouse, phone, texting & Sewing are susceptible to inflammation and progressive stenosis in the first dorsal tunnel of the wrist.
Thumb Pain Prevalence in Breastfeeding Mothers
In breastfeeding women, DQT is often termed as Pregnancy- Related DQT (PRDQT) & it is more prevalent in the postpartum phase. The women in this phase are at a higher risk of tendon inflammation due to repetitive hand movements involved in infant care.
Frequent lifting, holding, and feeding the baby in positions which can strain and inflame the tendons and their protective sheaths. Commonly, this condition resolves on its own after the breastfeeding phase ends, but in some cases the condition worsens as well. But before the symptoms spiral out of control, it is recommended to opt for physiotherapy interventions provided by ABTP. Physiotherapy can tackle the thumb pain by managing pain, reducing inflammation & improving the wrist and thumb function.
Let’s explore the way physiotherapy at ABTP can help in escalating the recovery process & prevent further complications.
Thumb Pain Seeks Relief at ABTP
Relieving Inflammation and pain : In the first stage, the ABTP experts help the patient to decrease inflammation, enhance tissue relaxation and relieve pain by leveraging ultrasonic massage , icing, and contrast bath.
Improvement of Flexibility: While training, the ABTP Experts focus on stretching the forearm flexor & extensor muscles so that flexibility is improved and it gets easier for the affected individuals to perform unrestricted movements.
Improving Range of Motion with Manual Therapy Techniques: At ABTP, various manual therapy techniques are incorporated such as soft-tissue mobilisation & Deep Tissue Friction Massage (DTFM). Different joint mobilisation techniques like MWM are used for decreasing pain, improving range of motion and enhancing function as well .
Development of Strength & Endurance: Eccentric strengthening exercises are followed for Extensor Pollicis Longus (EPL) & Abductor Pollicis Brevis (APB) muscles. This ensures that the individual gets back to work with reduced recurrence risks.
Return to Normal Activities: The patients are advised to avoid motions that evoke pain like those involving twisting and pinching with the thumb for a short period of time .This, then, enables the patients to promote healing process & return to daily activities with greater comfort. Ergonomic care: The primary aim of ABTP experts is to help patients realign their daily activities to avoid recurrence of injury. They assess the patient's workspace and hobbies, making ergonomic modifications to ensure neutral alignment of the wrists and hands during activities such as typing, knitting and breastfeeding. This helps reduce chronic overuse of the APL and EPB tendons.
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