Wrist Pain – De Quervain’s Tenosynovitis (DQT)
What is DQT or De Quervain’s tenosynovitis?
DQT is one of the most common wrist problems we see in clinic. It affects the tendons of the wrist and thumb and is made worse by repetitive use of the thumb.
I loved learning about it at University. The condition had a catchy name and so did the test used to help diagnose it (Finklestein’s test).
In truth, what I loved most about the condition and the test, was that I could remember the name! It made me sound like I knew what I was talking about, at least for a moment. In those first few months out of University, that was essential in a new Physiotherapy department. At least it seemed like it was, just to earn the begrudging respect of my older and more sage colleagues.
Even patients who used to tell us we looked too young to be a Physiotherapist, soon changed their tune when they heard the term ‘De Quervains’.
How I wish someone would tell me I looked too young nowadays!
Who gets DQT?
Traditionally we tend to see DQT in a mix of new mothers, young tradespeople, hairdressers and waitresses. All of them are doing a lot of lifting and repetitive actions with their wrists that presumably they weren’t used to doing before. In mothers, I’ve even heard it referred to as ‘mothers thumb’!
More recently things have changed!
Then came the advent of the smartphone and the trouble started. As the use of smartphones for social media increases, so seemingly does the rate of DQT.
In a recent survey study of around 500 people, over 50% tested positive for DQT. 40% said they had wrist or thumb pain using the smartphone and over 80% of those said it went away if they stopped using the phone.
Half the study group were rated as having problematic smartphone use. That meant spending more time on the phone each day (up to 10 hours was not uncommon and 6 hours was the average daily phone use).
Perhaps unsurprisingly, the rates of positive DQT tests were much higher in those who spent longer on the phone than those who spent least time (86% VS 35%).
What’s the Answer?
There is of course a simple answer. If you use your phone a lot and you’ve started to develop wrist and thumb pain, put down the phone and see if it helps.
In reality it’s not always so easy. So much of our work tasks are now done on the phone, from checking and replying to emails, online banking and even organising your sports teams and social lives. The potential to endlessly scroll is there.
At Head2Toe Physio we will assess, treat and advise you on how best to manage your condition. Whether that’s managing the acute painful phase or ‘bullet proofing’ you to prevent recurrences. If for you it’s not your phone, it may be something less obvious, like a job in the garden that’s causing it. Possibly a new serve action playing tennis. Sometimes it’s the case that you don’t need to give up your new slice serve, just strengthen and improve your bodies ability to withstand that new technique.
Whatever the cause, our physios will work with you to try and ease the pain and get you back to what you like doing best, even if that’s scrolling through twitter feeds!
All our Physiotherapists are highly qualified, experienced, with a variety of post graduate specialisations. If you or anyone you know would like to have a physiotherapy assessment with the team at Dorking , Leatherhead or Crawley , contact us here.
Blog post written by Sam Bowden, Head2Toe Physiotherapist and Director at Head2Toe Dorking, Leatherhead, & Crawley Clinics.
Benites-Zapata et al, Problematic smartphone use is associated with De Quervain’s tenosynovitis symptomatology among young adults, Musculoskeletal Science and Practice, 2021 53:1-6.
