This condition affects the lining of the tendon sheaths. Pain results from resisted gliding of the abductor pollicis longus and the extensor pollicis brevis tendons in the fibroosseus canal. Tendons are thick strands of tissue that connect muscles to bones. The three primary causes of stenosing tendovaginitis are occupational stretching of the tendon, repeated active contraction of the muscle moving the tendon, and direct injury, the stenosis being the residuum of a gross blunt injury. These devices will help decrease pain, limit movement, and protect your wrist so that it can heal. This irritation causes the lining around the tendon to swell, changing the shape of the lining and making movement of the tendons difficult. With a narrowing of the canal, the tendons are grinding on the canals walls. Both affections ethiology is directly re lated with hormonal changes occurred during pregnan cy.
The three primary causes of stenosing tendovaginitis are occupational stretching of the tendon, repeated active contraction of the muscle moving the tendon, and direct injury, the stenosis being the residuum of a. It can develop after a thumb injury, repetitive movements, rheumatoid arthritis and other. A 34yearold right handdominant female who works in a daycare facility presents with. Tendons control mobility within the extremities and are the tissues that attach muscle to hand and finger bones.
The tendons need to move through the canal by movements of the thumb. These women tend to develop symptoms about four to six weeks after delivery. You may have pain when you move your wrist or pick things up. The swollen tendons and their coverings rub against the narrow tunnel through which they pass. This is essentially inflammation and irritation of the extensor tendons of the thumb at the wrist. This disorder is generally caused by repeated awkward movements of the thumb over a long period of time. It gives rise to pain that is aggravated by active movements of the tendon or by passive stretching. A person with dequervains syndrome may have pain, tenderness, and swelling over the thumb side of the wrist, as well as difficulty gripping, wringing, or grasping. The result is pain at the base of the thumb and extending into the lower arm. Tenosynovitis is inflammation of the synovial sheath surrounding the tendon.
These tendons, called the abductor pollicis longus and the extensor pollicis brevis, go through a snug tunnel at the wrist, called the first dorsal extensor compartment. If you play too long, you might have gamers thumb, too. It usually occurs in middleaged individuals and is around 3x more common in women 80% of cases. These tendons are responsible for helping to extend the thumb, and they glide through a protective covering called a tendon sheath. If your case is more serious, your doctor may recommend outpatient.
It is a stenosing tenosynovitis of the abductor pollicis longus apl and extensor pollicis brevis epb tendons fig. This compartment contains the abductor pollicis longus apl and extensor pollicis brevis epb tendons. It occurs when the 2 tendons around the base of your thumb become swollen. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. It commonly manifests in parents of newborns because of repetitive lifting with wrists in radial deviation.
Keeping the wrist and thumb immobile to allow the inflammation to heal is the first step. Extensor pollicis brevis and abductor pollicis longus are two tendons located on the thumb side of the wrist. Tenosynovitis is defined as inflammation of a tendon and its enveloping sheath. The muscles and bones of the hand are connected by thick flexible tissue called tendons. These movements damage the pathways of important tendons in the wrist and thumb area, thereby resulting in inflammation. Vibration is a method of desensitization involving a steady movement initiated on the outer edge of the painful area and then travelling toward the center 18. It develops when the abductor pollicis longus apl and extensor pollicis brevis epb tendons around the base of the thumb become swollen, often causing inflammation to develop. Most cases are associated with overuse, however, local trauma can also precipitate the condition. A tendon sheath protective covering wraps around these tendons so that they can slide easily see figure 1.
This puts pressure on nearby nerves, causing pain and numbness. It is a progressive stenosing tenosynovitis whichaffects the tendon sheaths of the 1st dorsalcompartment of the wrist. It is most common among women between the ages of 30 and 50 years of age, including a small subset of women in the postpartum period. Vibration is a method of desensitization involving a steady movement initiated on the outer edge of. Pain is typically increased with gripping or rotating the wrist. Taking overthecounter antiinflammatory medication like ibuprofen can also help keep symptoms under control. Characterised by degeneration and thickening ofthe tendon sheath. It is a stenosing tenosynovitis of the abductor pollicis longus apl and extensor pollicis. Tendons are covered by a thin soft sheath of tissue known as synovium. Pain and tenderness at the base of the thumb andor on.
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