Return of de Quervain’s 12 years post-surgery
August 21, 2020 9:35 AM Subscribe
Return of de Quervain’s tenosynovitis 12 years after cortisone injections and release surgery. What can I do to treat it now? (Seeing doctor next Wednesday, just wondering what I should do until then and can’t ask them.)
My wrist was completely better after surgery (which I actually asked about here back then). But it started to bother me again a few weeks ago — I blame ramping up my yoga practice (felt it in down dog, upward facing bow, etc.). Plus I do a lot of knitting, using a rotary cutter, other crafting activities, and while they hadn’t been causing any problems all this time, I don’t think they helped with the new soreness. Stupidly, I pushed through the discomfort, which, in retrospect, was a really bad idea. Now my wrist hurts badly and it’s clearly progressed to where it was before surgery.
I’ve been wearing my old thumb spica splint since the acute pain started a few days ago, around the clock except for showering. I’m also icing it a few times a day, and I’m taking Advil.
But is that the right treatment for now? Some Google results (I know, I shouldn’t do medical research on Google) suggest that splinting isn’t actually effective. Plus I’m unconsciously tensing the hand and thumb all the time because the splint is uncomfortable — I relax when I think about it, but then I stop thinking about it and go back to holding it tense. I also read that some recommend doing strength and flexibility exercises even through pain, but I wonder if that just exacerbates the injury.
I’m unsure what can even be done medically since I don’t know if I can get cortisone injections again. I had at least two back then. But I read they’re actually degenerative if used too much? Is that true? And surgery probably wouldn’t do anything, right? I can’t do extended in-person physical therapy because of Life Responsibilities (plus COVID and all that).
Also, is this reinjury likely to cause really bad things because I’ve already had the release surgery? Isn’t the tendon sheath open? What does that mean for, I don’t know, the stability or health of the tendons now?
I’m asking here because I’m not in contact with my old hand surgeon— wouldn’t see him again anyway since I’ve moved. I was already planning to see a new primary care doc next week for an unrelated complaint, but I don’t want to call them because I’m not really their patient yet.
My wrist was completely better after surgery (which I actually asked about here back then). But it started to bother me again a few weeks ago — I blame ramping up my yoga practice (felt it in down dog, upward facing bow, etc.). Plus I do a lot of knitting, using a rotary cutter, other crafting activities, and while they hadn’t been causing any problems all this time, I don’t think they helped with the new soreness. Stupidly, I pushed through the discomfort, which, in retrospect, was a really bad idea. Now my wrist hurts badly and it’s clearly progressed to where it was before surgery.
I’ve been wearing my old thumb spica splint since the acute pain started a few days ago, around the clock except for showering. I’m also icing it a few times a day, and I’m taking Advil.
But is that the right treatment for now? Some Google results (I know, I shouldn’t do medical research on Google) suggest that splinting isn’t actually effective. Plus I’m unconsciously tensing the hand and thumb all the time because the splint is uncomfortable — I relax when I think about it, but then I stop thinking about it and go back to holding it tense. I also read that some recommend doing strength and flexibility exercises even through pain, but I wonder if that just exacerbates the injury.
I’m unsure what can even be done medically since I don’t know if I can get cortisone injections again. I had at least two back then. But I read they’re actually degenerative if used too much? Is that true? And surgery probably wouldn’t do anything, right? I can’t do extended in-person physical therapy because of Life Responsibilities (plus COVID and all that).
Also, is this reinjury likely to cause really bad things because I’ve already had the release surgery? Isn’t the tendon sheath open? What does that mean for, I don’t know, the stability or health of the tendons now?
I’m asking here because I’m not in contact with my old hand surgeon— wouldn’t see him again anyway since I’ve moved. I was already planning to see a new primary care doc next week for an unrelated complaint, but I don’t want to call them because I’m not really their patient yet.
The only thing that seems to help mine is ice and an ace bandage. For some reason, the bandage seems to help me more than a splint.
posted by The Underpants Monster at 10:37 AM on August 21, 2020
posted by The Underpants Monster at 10:37 AM on August 21, 2020
To answer your question about what to do in the meantime, before the doctor. I also had de Quervain. What helped me was going to weekly PT where they first put a heated goop on my hand and wrist; massage; very gentle exercises; then iced to cool down. So maybe at home, you could try this: a heated pad over the area, using your thumb to massage down and up gently in the area, and then icing it.
posted by inevitability at 10:42 AM on August 21, 2020
posted by inevitability at 10:42 AM on August 21, 2020
Response by poster: Thanks all so far.
The Underpants Monster, thanks for the bandage tip. I don’t have any ace bandage stuff, but I do have kinesiology tape left over from a leg injury. I tried taping my wrist as per this annoyingly long YouTube video I found and it’s feeling better already.
I’ll try heat and massage later.
posted by liet at 12:27 PM on August 21, 2020
The Underpants Monster, thanks for the bandage tip. I don’t have any ace bandage stuff, but I do have kinesiology tape left over from a leg injury. I tried taping my wrist as per this annoyingly long YouTube video I found and it’s feeling better already.
I’ll try heat and massage later.
posted by liet at 12:27 PM on August 21, 2020
You can find suggestions on how to do a paraffin treatment at home if you just a google it. (can't seem to link to my own google results)
posted by metahawk at 1:03 PM on August 21, 2020
posted by metahawk at 1:03 PM on August 21, 2020
Response by poster: Update: I’m feeling so much better since I stopped wearing the I’ll-fitting splint. A few days of kinesiology tape really helped.
I’m starting to wonder if the pain was even DQ at all — it was definitely the thumb joint and the inside of my wrist below the thumb, but at this point, it’s just soreness in the basal thumb joint. Plus some pain on the inside of my wrist (where the veins are) when it bears direct weight, like during plank pose. Yet down dog feels fine.
Finkelstein test doesn’t hurt, but range of motion is limited — which might be normal because of the surgery, not sure because I haven’t tried it in years.
Looking forward to seeing the doctor tomorrow and hopefully getting some answers.
Thanks all and sorry for the panic. If future searchers are looking for information about DQ surgery, don’t let me scare you off — the relief over the years since had been totally worth it.
posted by liet at 6:31 AM on August 25, 2020 [1 favorite]
I’m starting to wonder if the pain was even DQ at all — it was definitely the thumb joint and the inside of my wrist below the thumb, but at this point, it’s just soreness in the basal thumb joint. Plus some pain on the inside of my wrist (where the veins are) when it bears direct weight, like during plank pose. Yet down dog feels fine.
Finkelstein test doesn’t hurt, but range of motion is limited — which might be normal because of the surgery, not sure because I haven’t tried it in years.
Looking forward to seeing the doctor tomorrow and hopefully getting some answers.
Thanks all and sorry for the panic. If future searchers are looking for information about DQ surgery, don’t let me scare you off — the relief over the years since had been totally worth it.
posted by liet at 6:31 AM on August 25, 2020 [1 favorite]
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posted by AugustWest at 9:52 AM on August 21, 2020