DeQUERVAIN’S SYNDROME

DeQUERVAIN’S SYNDROME


DeQuervain's Syndrome

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DeQuervain’s Syndrome is, of course, named after the doctor who discovered it.  It is said to be a thumb ‘Tenosynovitis’ (inflammation of the synovium membrane or mucous-like ‘sheath’ that covers the tendons).  After over 15 years of treating this stuff, I would say that I really do not care what sort of fancy names you want to put on it, it is essentially a TENDINOSIS of two muscle tendons — Extensor Pollicus Brevis & Abductor Pollicus Longus; the muscles that make up an anatomical area known as “The Anatomical Snuff Box”.

DeQuervain’s Syndrome occurs at an area known as the Anatomical Snuff Box.  Let me explain.  Spread your fingers as wide as you can possibly get them, and at the same time raise your fingers ‘up’.  You can see the two thumb tendons mentioned above.  There is a small grove between them that apparently used to be used to hold the pinch of snuff that men would snort up their noses back in the day, in order to get them to sneeze (yeah; I don’t get it either).

The picture above shows the ‘Anatomical Snuffbox’.  The test for DeQuervain’s Syndrome — Finklestein’s Test — involves making the ‘thumb’s up’ sign, grasping your thumb with the fingers of the same hand, and pulling the thumb downward so as to stress or stretch the thumb tendons (kind of like you were casting a fishing pole).  If it hurts big time, you likely have it.

TREATING THOSE WITH DeQUERVAIN’S SYNDROME

Tendinosis, sometimes called tendinitis, or tendinopathy, is damage to a tendon at a cellular level (the suffix ‘osis‘ implies a pathology of chronic degeneration without inflammation). It is thought to be caused by micro-tears in the connective tissue in and around the tendon, leading to an increased number of tendon repair cells. This may lead to reduced tensile strength, thus increasing the chance of repetitive injury or even tendon rupture. Tendinosis is often misdiagnosed as tendinitis due to the limited understanding of tendinopathies by the medical community.”  Tendon researcher and orthopedic surgeon, Dr. GA Murrell from an article called, “Understanding Tendinopathies” in the December 2002 issue of The British Journal of Sports Medicine.

Plainly stated, I have had great results treating DeQuervain’s Syndrome over the years.  It is my opinion that as long as the problem is not part of a greater SYSTEMIC DISEASE PROCESS it is nothing more than glorified Tendinosis.  My brother and sister-in-law are both ER doctors in Topeka, Kansas.  DOCTOR KEVIN struggled with DeQuervain’s Syndrome for about a year (he hurt it doing pullups).  We met in K.C. for a weekend, where I was able to work on him.  One treatment and he was 95% improved.  Another treatment on Thanksgiving, and problem totally solved.  For my blog posts on DEQUERVAIN’S SYNDROME, click the link.

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