Each tendon is encased with a sheath of tissue which is called tenosynovium. This tenosynovium develops inflammation and leads to a painful condition called De-quivarians tenosynovitis. Pain is typicaly felt at the base of thumb which runs across the wrist to the forearm also.
This is commonly associated with repetitive activities making use of the same tendon. This is also seen in water retaining states like pregnancy, rheumatoid arthritis, hypo-thyroidism and other metabolic and endocrinal disorders. Most patients do extremely well with conservative treatment using medications and physiotherapy. While a few may even require a surgical release of the tenosynovial tissue. Metabolic screening remains imperative in these patients to rule out the basic cause.
De-quivarians synovitis is basically an overuse pathology and rest to the affected part remains imperative. In chronic cases, a local steroid is injected around the tendon sheath and a cast/plaster may be applied to give rest. In recalcitrant cases & where immobilization isnt possible, a surgical release may be the preffered modality of treatment.
De-quivarian’s tenosynovitis can be treated with physical therapy after the initial inflammation settles down. The video illustrates rehabilitation exercises for tenosynovitis which will help prevent reccurence of symptoms.
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