Tell me about how you managed De Quervain's (and/or a wrist splint)
February 15, 2016 5:18 AM   Subscribe

I have to wear a wrist splint 16/7 (just not while sleeping) for a month. If you have tips on living with it, would be grateful. If splinting fails to alleviate symptoms, it's going to be a cortisone shot. I am terrified of this and don't want it. If I *do* go for that and it fails, it's down to surgery, and I *definitely* don't want those risks! What's helped you? What should I be aware of, with this treatment plan? Are there alternatives?

This set of advice and instructions came from a sports medicine doctor who re-evaluated me after a return of symptoms that were previously managed with PT and rest. (My PT had not been keen on splinting, out of concerns about losing strength.)

Splint questions: is there a waterproof off-the-shelf splint? I find the times I often need it are when I'm washing dishes, cleaning, bathing. I'd like to swim, as well (with a flat hand). Any ideas about using my hands in a different way? Twisting, gripping, and applying downward pressure (e.g. opening jars, cutting food with a knife) are painful. Any tips on devices that can help?

Experiences with the cortisone shot and surgery are very welcome.

(I have benign hypermobility in many joints, if that makes a difference.)
posted by anonymous to Health & Fitness (14 answers total)
I had the cortisone shot — a minor, in-office procedure — and all my pain was completely resolved within 10 days. It returned 6 months later, and I had another one, which resolved it permanently (so far).That was four years ago.

The shot was momentarily painful, and the site was slightly achy for a few hours, but the tradeoff — fixing my persistent wrist pain — was so, so worth it.

Before that, I'd taken ibuprofen and worn a brace, which was extremely annoying, because of the getting wet issue. The brace didn't relieve any pain at all.
posted by purpleclover at 5:49 AM on February 15, 2016

Experience with the cortisone shot?

I had DeQuervain's for around 2 months. I was in so much pain I couldn't hold anything heavier than a glass. I couldn't work, bc I worked in a med research lab and couldn't do any experiments. This was wearing splints all the time. When I finally got a doctors appointment, I got the cortisone shot and was back at work, pain-free in two days. I wore splints for another couple of weeks, and took things easy, but the pain never returned.
posted by gaspode at 5:50 AM on February 15, 2016

(oh, this was nearly 8 years ago.)
posted by gaspode at 5:51 AM on February 15, 2016

Mod note: From the OP:
I'm afraid of the cortisone shot not because of pain, but because of research showing it damages tendons and other tissues over the long term. I understand that in this case, the injection is supposed to go into the tendon *sheath*; I haven't seen research to indicate possible long-term problems with that, but perhaps there are? I've read that one risk is the practitioner missing the target and hitting other tissue, which could lead to possibly permanent atrophy of the fat or muscle that got the cortisone. (I'm also unclear on *why* the sheath getting injected helps. Does it only alleviate pain? Does it help actually heal things in some way? I understand that the surgery, if it came to it, would be about *releasing* the tendon in some way; how does this affect the health of the tissue, and the way things function?)

(This is my dominant hand.)

Thank you for your experiences so far, which are very reassuring.
posted by taz (staff) at 6:17 AM on February 15, 2016

The shot relieves inflammation in the tendon and the sheath. I had one about five years ago. The shot itself was very painful but over quickly. My wrist was better within days and I've had no further problems.

However, I do find that if I spend too much time holding my phone, I will tend to get some inflammation. A few days of deliberately leaving my phone alone will cure it. Check your phone and/or tablet habits to see if this might be contributing to the problem.
posted by tamitang at 7:23 AM on February 15, 2016 [1 favorite]

I had this temporarily when I had a new baby (it's a classic new mother's injury--leftover ligament laxity plus picking up a baby under the armpits while supporting its head with your fingers multiple times a day). Fortunately it went away by itself with some exercises, but I feel your pain.

There are a lot of assistive devices that are marketed for people with arthritis that will help you with the kitchen stuff--lid openers, knives with big chunky handles, and so on (or you might consider duct-taping some foam pipe insulation around an existing handle). OXO makes a lot of these.

Hope the splinting works for you!
posted by The Elusive Architeuthis at 8:20 AM on February 15, 2016

If you have trouble tying your shoes, Lock Laces are amazing.
posted by FencingGal at 8:33 AM on February 15, 2016 [1 favorite]

I had a cortisone shot when I had De Quervain's. It made my wrist feel better for about 3 weeks before it started hurting again. Before that, it was constant bracing/splinting coupled with Aleve. None of that worked. What worked for me was a month long course of Celebrex.
posted by astapasta24 at 10:57 AM on February 15, 2016

I had De Quervain's and the doctor recommended the cortisone shot. I was nervous about it for the same reason as you, and decided to wait a bit before getting it. Here's what I did:

I completely stopped using that hand and let it relax all the time as much as humanly possible. I didn't make any attempt to move the thumb at all. I soaked the hand/arm in warm water to promote circulation, morning and night. I adjusted my sleep position so that my wrists were in a neutral position. I stay pretty still when I sleep, so this worked pretty well. The thumb was pretty much locked in position for the first 4 days or so (as best I recall; this happened 20 years ago) and then began to unlock slowly. First a little free movement was possible and that increased to full motion over about a week. I may also have been using aspirin as an anti-inflammatory, I don't remember for sure at this point. After a few more days I slowly resumed using my hand again, very gently and carefully at first. After another 3 weeks or so I was pretty much back to using it as normal. I have had no problems with it since. I'm still fanatical about sleeping with my wrists in a neutral position.

I am not a doctor and this is not medical advice. It's just what happened to me. Mine may have been a mild case for all I know (despite being painful and having the thumb lock up). Ask your doctor if this is a reasonable thing before trying it.
posted by DarkForest at 2:59 PM on February 15, 2016

Also, I did not use any sort of splint.
posted by DarkForest at 3:01 PM on February 15, 2016

I had several cortisone shots and they didn't work for me. They were *extraordinarily* painful and required that I continue to take narcotic pain meds to get over it, which defeated the point of the shots in the first place. I took a ton of Vicodin and gritted my teeth for something like a year with no relief.

I eventually had the surgery (deQuervain's release), and it was a miracle. It's about 10 years later now, and I still haven't had a relapse. Zero side effects. It was totally worth it. It was my dominant hand and I was worried about losing function, because I like to work with my hands and play video games with a controller, but the only lingering effect has been a scar. I even have a hobby that revolves around a repeated pinching motion between my thumb and forefinger (spinning yarn), and I can do it for hours on end for days and experience no pain.

I don't remember much about splinting, but I know it was especially important at night to make sure I didn't sleep with my wrist bent because that would make the next day hell. And of course you need to use the special splints that support your thumb (not the carpal tunnel splints from the drugstore that leave the thumb open). I had to get mine from the hand doctor.
posted by liet at 3:09 PM on February 15, 2016 [1 favorite]

I've had different wrist/hand issues, not De Quervain's. For night-time splinting I found a soft IMAK split (e.g. much more comfortable for sleeping than alternatives, but those might not be suitable in your case.

My one observation concerning cortisone injections is that if you're someone who has a history of reactions to needle procedures (e.g. faintness when blood is drawn), definitely let whoever is doing the injection know so that they can make adjustments such as having you lie down during the procedure if possible, and generally be ready for the possibility of a reaction. My one experience with a cortisone injection was via guided fluoroscopy fairly deep in my wrist; the injection went on seemingly forever and I started getting faint only to discover that the two people doing the procedure weren't especially prepared to deal with the situation. Luckily I stayed conscious but it was one of my more unpleasant medical experiences.
posted by Creosote at 4:34 PM on February 15, 2016

I had De Quervain's. Ice! Really lots and lots of deep icing, really working it in. There was some therapist who had a web site years ago that I can't find now who advocated ice for all sorts of tendon and ligament pain. He suggest freezing water in dixie cups and using them to work ice deep into the inflammated areas. After a few minutes of massaging and digging in with the ice you realize that your body tells you when you are doing good and when to let up short of frostbite or tissue damage. You quickly find the exact "hot spot". It took a few days of 5 minute treatments every 3 or 4 hours but it actually worked! I've never had cortisone do me any good for anything.
posted by Chitownfats at 11:04 AM on February 16, 2016

PS. The Elusive Architeuthis: De Quervain's is often referred to as "Mommy's Thumb" for exactly what you described.
posted by Chitownfats at 11:12 AM on February 16, 2016

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