De Quervain Syndrome is characterised by a cluster of symptoms in the wrist and thumb base regions. Physiological changes in the tendons that move the thumb (extensor policis brevis and abductor policis longus) lead to inflammation and a painful affliction with limited scope of movement. Anatomically, there is a thickening of the thumb tendon sheath, which affects mobility of both the finger and hand. The most common causes of the syndrome are frequent activities with overuse of thumb muscles. The condition is frequent in various medical professions (surgery and dentistry), as well as among craftsmen (auto mechanics, plumbers), etc.

Symptoms

Palpatory sensitivity and pain in the root of the thumb, with swelling and limited mobility. Pain can also occur during certain movements: flexing, extending, abduction, circumduction (circling), which can impede daily activities to a great degree.

Treatment

Rehabilitation depends on the stage of the condition. The acute stage is characterised by severe pain in the evenings, followed by swelling and redness. Various physical agents need to be applied in order to prevent further aggravation and reduce the severity of the symptoms. The application of Bemer machines, combined with high-intensity laser treatment (HILT) and other modes of physical therapy all lead to improvements in local microcirculation and have an anti-inflammatory effect, which leads to pain reduction and recovery.

The issue can often become chronic in nature and hence resistant to physical therapy, in which case manual therapy is the preferred course of treatment, and Mulligan Pain Release Phenomenon (PRP) concept is especially effective in this stage.

After the physical treatment is complete, it is necessary to restore functionality of the finger ad hand, which can be achieved with kinetic therapy under the supervision of our experts.

Miloš Radosavljević
Chartered physiotherapist