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Tendovaginitis de Quervain
contents
- definition
- causes
- symptoms
- diagnosis
- treatment
- Naturopathy in Tendovaginitis de Quervain
definition
The extensor tendons of the thumb (from the muscle abductor pollicis and extensor pollicis brevis), as well as the extensor tendons of other fingers, run in a kind of tunnel called the tendon compartment. In Quervain's disease, the first tendon of the hand is affected. Here an inflammation forms, which subsequently causes corresponding complaints. In the International Classification of Diseases by the World Health Organization (ICD-10-WHO Version 2016), the complaint is reported under "M65.4 Tendovaginitis stenosans [de Quervain]". Other terms used include, for example, Quervain Disease, Quervain Tendovaginitis and Quervain's Disease.
Tendovaginitis de Quervain is associated with sharp pains during movement of the thumb. (Image: Adiano / fotolia.com) causes
The causes of Quervain's disease have not been conclusively resolved to this day, but misuse or overloading is a clear risk factor. Activities in which there is a frequent spreading of the thumb, such as typing short messages on the smartphone, but also holding the child while breastfeeding and many activities in the household are accompanied by corresponding excessive strain on the thumb (sometimes the symptoms are also called Hausfrau thumb ).
However, overloads are not the only known risk factors. Also, physicians assume a connection with existing lack of space in the first tendon. Here, the tendons may rub against each other, which subsequently causes the Tendovaginitis de Quervain. In addition, in some people - as an anatomical feature - run instead of two three tendons in the first tendon, which of course follows a certain tightness that favors the occurrence of the disease. In these cases, there is a kind of anatomical predisposition to the disease.
symptoms
Pain during movement of the thumb are an essential feature of Tendovaginitis de Quervain. These can radiate from the area below the thumb joint over the back of the hand to the forearm. There may also be swelling and local pressure pain in the area of the first tendon. Also, some sufferers feel a sense of rubbing in the tendon area during thumb movement. In the long term, failure to treat at the most threatened scarring and adhesions of the tendon in the first tendon, which is associated with corresponding restrictions on the mobility of the thumb.
diagnosis
As a reliable local test for the diagnosis of Quervain disease is the so-called Finkelstein test, named after the American surgeon Harry Finkelstein, who described this early 20th century in a corresponding technical work. The hand is held practically as in a handshake, only clearly tilted down and pulled the tip of the thumb down towards the little finger. If this causes pain in the area of the lateral-lower end of the spinal column, the so-called styloid process, this is to be regarded as a clear indication of Quervain's disease.
Differential diagnosis can also be used imaging methods such as X-ray examinations, for example, to rule out joint diseases in the form of a Rhizarthrose. In addition, a holistic approach to all inflow and outflow routes of the hand vessels are examined, with several bottlenecks in the arms and shoulders are taken into account. Especially with breastfeeding mothers there are often factors that can lead to a jamming of the vessels outside of the wrist and thus a congestion. In addition to the mechanical factors hormonal and metabolic peculiarities, which all influence the quality of the tissue, should be included in the anamnesis.
The immobilization of the thumb is usually essential in the case of Quervain's disease. (Image: TasfotoNL / fotolia.com) treatment
Protection or immobilization of the thumb is the basis of the therapy. Further congestion is urgently to avoid. A tape bandage, a splint or a plaster bandage can provide relief here. Accompanying it are often administered anti-inflammatory drugs. Also, manual therapies are an essential part of the treatment and in most cases, the symptoms can be remedied with the measures mentioned after some time. If this is not the case, cortisone can be used against the disease, but there is no guarantee for success. The last option is an operative procedure in which the first tendon compartment is opened lengthwise and possible restrictions or adhesions are eliminated.
Naturopathy in Tendovaginitis de Quervain
In addition to the possibilities of manual therapy, various external treatments are available in natural medicine in the case of Quervain's disease. In particular, envelopes based on aluminum diacetate (acetic alumina) and cold clay wraps, which are applied over several hours (preferably at night), here a positive effect is awarded. In addition, various homeopathic remedies can be used, in addition to Arnica especially Rhus toxicodendron is often used here. (jvs, fp)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)
Picture 1: Lupo