Modern medicine is fascinating in many senses – first, that it has gotten so in-depth and detailed because of years upon years of scientific discovery and analysis, and second, that it has become so accessible to the average person thanks to greater transparency than ever and a more immediately available flow of information. As such, it makes us aware of a lot of things that could be going wrong with our bodies, or at least allows us to quickly find out more about root causes that might be bringing about pain or discomfort. Furthermore, it allows us to more readily find out what we can do to recover from these varied possible maladies.
One potentially unfamiliar such malady is De Quervain’s Syndrome. You might not have ever heard of it, even though you might have actually felt the symptoms. Alternatively, you might be more familiar with an alternate name for this issue. For instance, one such alternate name is New Mom’s Syndrome – while some might be eager to just call this De Quervain’s Syndrome instead in order to avoid the stigma, but the name actually conveys the main cause behind it. In their case, new moms are constantly adjusting to picking up and cradling their babies, which results in the condition developing and thus causing pain.
A more technical name for De Quervain’s Syndrome is tendinopathy, and indeed it takes two forms, particularly De Quervain’s Tendinitis and De Quervain’s Tenosynovitis. The simple truth of it is that De Quervain’s syndrome is essentially an overuse injury, resulting from chronic overuse of the wrist. The main part of the wrist that gets affected here is the tendons. As one might know, tendons are the rope-like structures that connect the muscles to the bones that form the joints. Gripping anything with your hand pulls on tendons in the wrist and lower thumb, which typically glide smoothly through a tunnel in the hand that links them to the base of the hand. This is normal functionality, but all normal functionality in the body can be stressed if done too much.
As with most overuse injuries, the repetitive motion of dong this strains the tendons, mainly irritating them and causing some inflammation and thickening that makes movement difficult if not painful. Additionally, outright injury can produce scar tissue that can interfere with proper tendon movement; inflammatory arthritis can also produce the same internal conditions that result in discomfort and pain when moving the wrist. Risk factors that can increase the likelihood of having De Quervain’s syndrome include age – this tends to affect people between the ages of 30 and 50; sex – women are more commonly affected, although this isn’t exclusive to women; and tasks or situations that require that repetitive motion, such as having a baby to lift and cradle or having to perform these movements for work or as part of a daily routine, which can produce the repetitiveness and constancy that would cause that irritation over time.
Medication for De Quervain’s Syndrome tends to follow the same pattern as most other tendon-based overuse injuries, typically involving non-steroidal anti-inflammatory drugs. All medication should ideally be prescribed by a doctor rather than self-chosen, of course. Over-the-counter pain relievers, such as naproxen and ibuprofen, are usually the go-to options.
If the tendon sheath is diagnosed as particularly swollen and in need of aid, your doctor might recommend injections of corticosteroids to help that along. Your doctor should make sure to ensure that the injection goes to the sheath for the tendon rather than just subcutaneously or below the skin. The latter can result in dermal atrophy and increase in fat, both of which are untoward consequences you’d just as soon avoid.
If De Quervain’s Syndrome is caught early enough – within the first six months of the symptoms manifesting – a person can usually recover well enough after just one injection treatment. About 50% of patients permanently recover from just one injection; another 40-45% need a second one about a month after the first. As always, you can probably help the healing process along by consuming food known to be helpful in curbing inflammation and the like, such as oily fish with omega-3 fatty acids, spices like garlic and turmeric, and so on.
Therapeutic treatments for De Quervain’s syndrome will usually try to address the root of the problem, which is the movement that had caused overuse. This might include a splint designed to immobilize the thumb and wrist, bracing them in place to keep them from bending too much and further irritating the tendons and instead giving these a chance to rest. Typical R-I-C-E treatment may also be prescribed, particularly applying ice to the wrist in order to alleviate the swelling and diminish the pain that might be affecting the nerves in the area.
Essentially, being aware enough to give the area enough rest and stop giving it a workload to take care of will also help, especially since giving the tendons a change to rest and recover from the irritation will give them a window within which the swelling can be allowed to go down rather than constantly aggravating it and causing it to flare right back up when it could already be slowly diminishing. This can be tricky though, as splinting or bracing the thumb and wrist and keeping them from moving effectively renders the hand useless for most tasks – which is why many patients have trouble constantly remembering to rest and keep the splints on.
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