Testing for de Quervain's Tenosynovitis
You may have heard about a newer way to test for de Quervain’s Tenosynovitis. This test applies stress to the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons without stressing the thumb and wrist joints.
Along with this testing standard for de Quervain’s, the terminology used to describe the condition has also changed over the years.
In the past, tendinitis and tenosynovitis were the general terms used to describe painful tendon conditions thought to be due to inflammation. However, now more precise descriptive terms for degradation of the tendon as opposed to inflammation of the tendon or surrounding soft tissue are being used - tendinosis and tendinopathy.
- Tendinosis describes the degeneration of the tendon’s collagen from overuse and repetitive strain, such as tennis elbow. Without time to heal, the degeneration is chronic and the tendon cannot properly heal. But, there is no inflammatory process.
- Tendinopathy is a more general term used to describe tendon pain caused by inflammation and micro tears, such as the inflammation of the synovium and tearing of the tendons that occurs in de Quervain’s.
While terminology may change, the condition and the pain still need to be treated.
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Splints and Braces for de Quervain's
Splinting remains a first-line conservative treatment. Depending on the severity and longevity of the symptoms, splinting choices may be soft flexible splints for mild or occasional symptoms, moderately restrictive splints for more severe and persistent symptoms and firm supports that restrict motion for more severe, long-standing pain.
The 3pp Ez FIT ThumSpica Splint has a full length aluminum stay that can be custom contoured to position the thumb and wrist. Open palm design leaves the ulnar border of the hand free for excellent function and patient compliance.
It is important to follow patients after a splint is issued. If symptoms do not improve with a full time splint wear regime, patients should be referred for treatment or a surgical release.
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