Fields of treatment / Orthopedy / De Quervain’s disease
De Quervain’s disease
De Quervain’s disease is a common cause of hand and wrist pain.Destruction and inflammation of the tendons and their sheaths in the area of the thumb makes pain-free movement impossible when moving the thumb in the space of the fibrous loop.
Symptoms
- Long-lasting pain just above the carpal fissure, worse when moving the thumb and moving the wrist sideways.
- It is often the result of stereotypical hand movements at work and chronic overuse of the wrist. It appears more often in middle-aged women, but De Quervain's disease does not avoid men either.
- The area is sensitive, it may be swollen, simultaneous bending of the thumb and wrist towards the edge of the little finger causes a painful reaction, sometimes you can even feel a "creaking" in the area
Treatment
In the non-operative method of treatment, a steroid injection is applied, the thumb and wrist are immobilized using rigid splints.This conservative treatment can bring relatively quick relief, but in case of further straining, there is often a relapse and a renewal of pain.
Therefore, surgical treatment is recommended, shortening the duration of the disease and limiting recurrence.In surgical treatment, a small incision is made in the area above the carpal fissure and the affected fibrous loop is cut.
A possible complication of surgical treatment can be disruption of the nerve responsible for sensitivity on the back of the hand. This disturbance is manifested by tingling and reduced sensitivity of the affected part.If this complication occurs after surgery, the nerve needs to be sutured.
Postoperative care
Elevated position of the operated limb (elevation) - relieves pain and reduces swelling. Adhesions are prevented by active and passive exercise.
It is advisable to care for the scar with the help of pressure massages and mobilization of the scar, or a special silicone gel can be applied, which minimizes the formation of swelling and adhesions.
Manually working patients return to work after two weeks, others even earlier.
