Dequervins Syndrom

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INJURY TITLE

Dequervins Syndrom

 

INJURY OVERVIEW

This is very common repetitive use injury affecting many people from golfers, to racket sport players, to new mums.  It is normally felt at the bottom of the thumb and the end of the wrist on the thumb side.  Depending on the severity of it the pain can include more of the thumb and the surrounding area.  Most thumb and wrist movements will aggravate it.  The use of tennis rackets and golf clubs (gripping), and particularly picking up children are also common irritants.

 

INJURY IN-DEPTH INFORMATION

It is important to note that despite the pain being local to the tendon it doesn’t really mean you have a tendon problem.  The pain arises from irritation of the tissue (namely a synovial sheath) surrounding the tendon.  This tissue acts like a tunnel for the tendons to pass through.  If this becomes inflamed it’s harder for the tendons to move.  As the condition progresses, the inflammation can worsen making it harder and harder for the tendons to move.  It can reach a point where the movement of the tendon causes more and more irritation, and so the condition essentially drives itself

 

COMMON SIGNS & SYMPTOMS

The symptoms usually creep up on you and can include the following:

Local tenderness and swelling along the tendons.

Tender to touch at the bottom of the thumb where it meets the wrist.

DEMONSTRATE WHICH MOVEMENTS COMMONLY HURT

 

HOW IS IT ASSESSED

For this injury, XRAYS, MRI, diagnostic ultrasound are really not needed.  There are many different structures in this area.  If your examining clinician suspects those then they will refer you for the appropriate tests, but for this SIMPLE condition, the following is all that is required:

  • There are a few clinical tests that will help (show them),
  • It’s really down to the information that you give to the clinician.

 

 

 

GENERAL TREATMENT

A simple splint for your thumb (that holds it in a nice functional position) could be all you need here.  Also, there are always a few aggravating movements or activities (specific to you), that will worsen your symptoms.  Addressing these appropriately is the single best intervention – these are usually the root cause.

 

In severe cases a local injection of cortico-steroid will certainly help, but reducing the repetitive activity is really the most influential option

 

Exercise Videos: i.e.

  • Rotator cuff strengthening
  • Pec stretch
  • etc

 

WHICH HEALTH PROFESSIONAL TO CONSULT

PHYSIO     X

MEDIC     X

PODIATRY     

Put an ‘X’ next to each health professional that most commonly deals with this injury.

i.e. tennis elbow would be Physio and Medic as injections are common, whereas for muscular LBP it would be Physio and not Medic as they would just refer them to a Physio.

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