If DeQuervain’s is diagnosed, that means your doctor has found a name for the pain and tenderness on the outside of your thumb. The pain might feel sharp, like a stabbing pain, and happens when you move your hand a certain way.
DeQuervain’s may also cause difficulty for you when you are making a fist or trying to grip or grasp something. Since it can have several symptoms (pain, gripping difficulty) it is a “syndrome.” A syndrome is a collection of symptoms.
Arthritis of the thumb can have similar symptoms. I suppose it’s possible that they have much the same cause. Muscles cause arthritis (some muscles too “tight” and some too “weak–pull on the joint and cause bony changes.)
Arthritis is caused by using the body in an out-of-neutral position and DeQuervain’s is caused by excessively tilting the hand at the wrist, which would also be out-of-neutral position.
What is it? Apparently, it’s not a true “itis” or inflammation of the tendons, although many doctors call it “tendonitis.”
More likely, it’s an irritation of the tendons at the base of your thumb. The tendons pass through a tough band of tissue. According to David Nelson MD, restrictions occur while the tendons are passing through this band, possibility because of thickened tissues and increased blood flow.
Does a brace help? There are some braces which prevent the thumb from moving and the wrist from tilting. They may help by eliminating the ability of your wrist to tilt from side to side, but when they are no longer being used, your pain may come back.
If a brace can “train” you to do a movement correctly, rather than tilting, then perhaps it’s good to wear for those times when you do the “wrong” thing. They cost approximately $23 to $30 at this time and it looks like they do keep your thumb from moving, too, so you’d just have to try and see if it would work for you.
When people become aware of the motion they make that’s causing symptoms, they can often stop doing it without a brace.
Two clients who did this stopped the twisty-ripping motion of ripping bandage packages open and of vacuuming with a twisty-wristy position.
What about surgery? Surgery is available, of course. The surgeon cuts the band of tough tissue so the tendons can move freely. Apparently, sometimes they can move TOO freely because sometimes when a patient flexes or extends their wrist fully–and at the same time does forceful movements of their thumb–the tendons that are no longer contained by the band of tough tissue can pop out of position.
Any surgery can have side effects, and even though this one is usually done on an out-patient basis, many patients report quite a bit of pain afterward, much more than they expected.
Dr. Nelson says that steroid (cortisone) injections (shots) are helpful in about 82% to 95% of the patients. I’d go with the steroid shot first.
How is it diagnosed? Easy. If you tuck your thumb into your hand, and tilt your hand in the direction of your baby finger (toward the outside of your arm) and it hurts a lot, you have just made the diagnosis.
What causes deQuervain’s? There are 3 movements your wrist can make. 1) bending forward, or palm-ward, 2) bending backward, or toward your elbow, 3) tilting side to side or from the thumb side to the baby finger side (and baby to thumb.)
Doing fairly equal amounts of the 2 bending movements is okay. The wrist is called a “hinge” joint. That means it’s made to move in those directions.
But the tilting movement, well, it’s not built to move that way too often and therein lies the problem.
Some people have a job that causes them to tilt their hand a lot and that aggravates those tendons. Some people do things in a way that they don’t have to (it’s just become a habit), and that causes tendon irritation, too.
I’m thinking of a hospital worker who ripped
lots of bandage packages open every day. Her wrist started to hurt (she thought it was carpal tunnel.)
Turns out, a lot of other people who work with her had also had this problem. On my suggestion, she started cutting the packages open instead of ripping them, and her pain went away.
Pain doesn’t happen unless there is a reason.
What do you think? Well, you know that I’m not a doctor but this is something I have had personal experience with a few times. “Personal” as in my own wrist.
And, you may know that I’m a soft tissue expert.
I give full responsibility to the muscles and soft tissues (that means not bones) that cause probably 90% of our pain. And, I am a firm believer in doing the most natural, least invasive therapy possible and that often includes massage therapy.
I KNOW that bodies can heal when they are given what they need to be well and when the things that make them un-well are removed.
Dr. Nelson had a very interesting page that talked about anatomical variations between those who have deQuervain’s and those who don’t, and that could be.
Regardless, the tilting movement seems to be the demon here.
The tilting motion stretches, pulls or aggravates and irritates the soft tissues on the thumb side of your wrist.
1. If you can manage to quit doing that tilting movement, in time you will heal, settle down, and stop having pain. Sometimes, awareness is enough to help you quit doing a movement. If you didn’t realize you were doing it, how could you stop doing it?
2. If you pinch the soft tissues around the base of your thumb, and on the thumb-side of your arm near your wrist, you’ll find they are tender. Very tender. You can ice this area, heat this area, massage this area of your lower arm. You can pinch the tissues, twist the tissues, or go to a massage therapist and let them do it for you.
3. Do all of the same pinching, prodding, poking and playing with the muscles and soft tissues on your thumb and in the web of your thumb, too.
Those tissues have become irritated because of the tilting movement. They’ve become tight and are a little less happy than they used to be.
Massaging them and pressing into the tender areas will help get the circulation going again and relax those tight tissues. Manipulating, icing and/or heating the tissues around your thumb and lower arm will help them become more pliable, healthier and happier.
There you have it: My all-natural, do-it-yourself 3-point system for getting rid of your deQuervain’s Syndrome: Stop the offending movement, Massage and treat specific muscles, and get natural relief from deQuervain’s Syndrome.