De Quervain’s Tendinosis: Symptoms & Treatment

De Quervain’s Tendinosis is a medical condition due to the irritation and inflammation of the tendons located at the base of the thumb. Tendinosis simply refers to swelling of the tendons and this will ultimately result in pain and discomfort for patients. This pain is further intensified when activities involving the thumb is initiated such as gripping a plastic bag or clenching a fist.

Located in our thumb are 2 main fibrous connective tissues known as the tendon. The tendons are the ones responsible for attaching our muscles to bones. In order to provide cushioning support, synovium fluid is coated on the tendons so that they can slide easily. When the tendons swell or thickens, friction will be increased and this will result in tendinosis.

Symptoms

In the initial stages of tendinosis, the pain will be random. It may appear slowly or suddenly and will travel from the wrist all the way up to the forearm. After a few days, presence of swelling will be obvious over at the thumb side of the wrist due to an excess of bodily fluid accumulated. When the thumb is in use, there may be feelings of instability and a snapping sound might be heard. Due to the swelling and pain, the thumb and entire wrist may be difficult to use.

 

Treatment

The main aim of treatment is simply to reduce irritation and swelling that is responsible for pain. Non-surgical treatment will be administered first to see if patients can respond well.

Splints

Splints act as immobiliser to properly rest the thumb and wrist to prevent further aggravation to the condition. It will be worn over a period of several weeks until signs of improvements are seen.

Anti-inflammatory medication

Anti-inflammatory medication as its name suggests are administered either orally or locally through injection to reduce inflammation, swelling and ultimately relieving pain.

Corticosteroids

Corticosteroids will be injected directly into the site of the inflamed tendon. The corticosteroids will enter into the cells and combine with the steroid receptors, inhibiting the synthesis of proteins which are responsible for swelling.

Surgery

Surgery will be required for cases that do not respond well to non-surgical means. An axillary block will be performed to put the hands to sleep. A small incision will be made and the wrist will be thoroughly cleaned with anti-bacterial solution. The tunnel will be opened up to make space for tendons so that it does not rub against the tunnel.

Arthritis of the Hand: Symptoms & Treatment

Arthritis is the generic name for inflammation in the joints. It can take many different form and the most common one is osteoarthritis. Osteoarthritis is the medical condition when the protective cushioning known as the cartilage is worn out due to wear and tear. It usually happens in areas such as the hand. In this article, we will look at some of the symptoms and treatment for hand arthritis.

Pain

Pain is the most straightforward symptom for any kind of medical conditions. In the initial stages of hand arthritis, the surrounding area will start to have a burning sensation especially after periods of long usage. This pain can be immediate or delayed. As wear and tear of the cartilage continue to take place, the pain will start to be more intense and the frequency increases. After long periods of rest such as after waking up in the morning, the pain can be quite unbearable and the ability to sense changes in weather also appears. Simple activities such as carrying a grocery bag or opening a can be difficult to accomplish.

Crepitation

After some time, there will be sensations of crepitation. This is due to the damaged cartilage rubbing against each other to create a grinding effect. If the hand arthritis affects the hand ligaments, the ligaments and tendons may start to become loose, creating a sense of instability.

Swelling

Swelling occurs due to an excess of body fluid accumulated in the hand. This is due to the body’s natural defence mechanism sensing that something is wrong. As a result, the white blood cells start to destroy the damaged cartilage, secreting a lot of fluid as a result. This will result in pain and tenderness in the hand.

 

Treatment is classified into non-surgical and surgical methods. In non-surgical treatment, the doctor will prescribe medication to stop the inflammation such as acetaminophen and ibuprofen. These medication can only treat the symptom but cannot repair the damaged cartilage. To counter this, glucosamine and chondroitin may also be prescribed as supplements.

If non-surgical treatment fails to produce good results, surgery will be necessary. The most common form of surgery is finger joint replacement. The replacement materials are biocompatiable and possesses weightbearing capabilities such as ceramics. This will help to restore function to the hand and improve the quality of life.

Cartilage do not self-regenerate and this is why joint replacement is the most viable option up to date.

Possible Causes For Carpal Tunnel Syndrome

Carpus is derived from the Greek word “karpos” which means wrist. Our wrist is supported by fibrous connected tissues. The space between these fibrous tissues and the wrist bone is the carpal tunnel and the median nerve passes through this tunnel and signals are passed from the brain to the wrist through this nerve. If swelling occurs at the fibrous tissues, it can irritate the median nerve and disrupt nerve communication which will result in numbness of the fingers, medically known as “carpal tunnel syndrome“.

The main causes of carpal tunnel syndrome is split up into 2 groups namely the biological causes and the working causes. Although there are 2 groups of causes, it is not easy to determine the exact cause of carpal tunnel syndrome as there are no specific tests that can be conducted.

Biological causes

Biological causes such as inflammation can cause carpal tunnel syndrome. Inflammation can occur either through injuries, existing medical problems or insufficient rest between intensive usage of the hand.

Working causes

Preliminary studies have shown that most of the causes are due to working causes. Repetitive usage of the wrist may increase the pressure acting on the median nerve and increasing the chances of getting carpal tunnel syndrome. Constant repeated motion such as swinging a tennis racquet or golf club as well as typing on the keyboard for long period of time may aggravate the condition.

Medical conditions

Some medical conditions may increase the risk of contracting CTS. Some examples of them are diabetes, arthritis, osteoarthritis, obesity and pregnancy. One of the complications of diabetes is CTS. Diabetic patients are prone to neuropathy and this can affect basic sensations. Patients who rely on kidney dialysis are also prone to contracting CTS. A damaged kidney will result in the build up of beta 2-microglobulin, a type of protein. This protein will increase the risk of getting CTS.

Genetics

Genetic factors may also increase the risk of CTS. If you have family members who have CTS, you are at a higher risk. CTS can run in the family.

Pregnancy

During pregnancy, there is an increase in fluid retention and swelling. This will increase the pressure build up in the wrist bone and compress the median nerve, causing CTS.

Leading a healthy lifestyle will decrease the risk of Carpal Tunnel Syndrome. Ensure that your work space is ergonomic and you do frequent stretches to relieve pressure off your hands.