De Quervain Tenosynovitis (DQT) Management & Treatment

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DQT - also known as the "Mommy's thumb" or "Blackberry thumb" is a common cause of pain in the thumb side of your wrist. This is usually related to repetitive strain of the thumb tendons under the retinaculum sheath. The two main tendons affected are APL (Abductor Pollicis Longus) and EPB (Extensor Pollicis Brevis).

2 Tests to Identify and confirm DQT
a) Palpation Test ( static & thumb movement)
b) Finkelstein Test ( gripping thumb in your fist and adduct the wrist)

Management Progression is listed below.

1) Early Stage - lots of pain and tenderness with little movement
a) Rest
b) Splinting with Thumb Spica Splint
c) Activity modifications - breastfeeding, picking up the baby etc.
d) Medical management - Advil, Tylenol, Voltaren EmuGel, Cortisone
Injection
e) Massage of the muscles INSTEAD of directly on the tendons

2) Intermediate Stage - pain occurs with certain movements and when you
need to use more force.
a) ROM ( Range of Motion) Exercises
b) Stretching exercises of the thumb and the wrist
c) "Finkelstein" Stretch with thumb in the grip

3) Late Stage - pretty much pain-free but feels weakness
a) Rubber band exercises - Abduction & Extension
b) Gripping and squeezing exercises

DQT usually takes a few months to recover as the cause is usually a gradual onset with repetitive use so be patient with your recovery process and don't give up too quickly.

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