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Texter’s Thumb, otherwise known as ‘De Quervain’s Tenosynovitis’ is a painful condition resulting from inflammation and swelling of the tendons which control thumb movement.
The Anatomy
Tendons are rope-like structures that attach muscle to bone. Tendons are covered by a slippery thin soft-tissue layer, called synovium. This layer allows the tendons to slide easily through a fibrous tunnel called a sheath.
In normal circumstances, the tendons of the thumb can glide freely as they pass underneath the tendon sheath; the thickening and inflammation of the tendons and/or sheath results in narrowing of the tunnel- causing friction and therefore pain.
Typically this is an overuse injury that can lead to thickening of the sheath; which may also lead to compression on the surrounding nerves.
Causes:
- Repetitive strain/ overuse- due to occupation or hobbies
- Trauma- may lead to scar tissue forming, resulting in thicken of the sheath or tendons.
- Pregnancy- hormonal changes causing fluid retention increases compression in the area and also overuse from nursing a newborn.
- Inflammatory conditions- such as Rheumatoid Arthritis, causes widespread inflammation of the joints throughout the body.
Symptoms:
- Pain felt over the thumb side of the wrist- pain may appear gradually or suddenly. Pain can travel up from the wrist to the forearm.
- Pain worsening with use of the thumb or wrist.
- Swelling over the thumb side of the wrist.
- A palpable nodule at the base of the thumb.
- A ‘popping’ or ‘snapping sensation’ may be felt when moving the thumb.
- Pain and swelling may restrict movement into the thumb and wrist.
Manual Therapy treatment:
Manual therapy can be a great non-invasive option to treat this condition. The primary aim of treatment would be to focus on decreasing inflammation of the tendons and surrounding muscles. This can be done by using soft-tissue massage, ultrasound therapy, or shockwave therapy. Increasing the mobility through the joints surrounding the thumb would also decrease the load on the tendons and thumb, to aid recovery.