Inflammation of the tendon’s sheath (what surrounds tendons) of the thumb is referred to as De Quervain’s Tenosynovitis.
This is a painful condition of the thumb that can make typing, texting, writing or golfing very painful.
How might a professional massage therapist massage the thumb tendons and the surrounding tissue to bring relief?
In the video below I demonstrate a tip on how I do it.
What causes De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is the inflammation of the sheath, or synovium, that surrounds the two tendons that run between the wrist and the thumb.
Example: Slide your hand and arm up a long sock. That sock is the sheath and your arm represents the tendons. The sock allows the arm to slid in and out to reduce friction on the skin. Just like a sock reduces friction in the shoe.
Now take a very small sock that you can barely get your hand into, and slide it in.
Very difficult, right?
And if you were fortunate enough to get that tight sock on, it is only a matter of minutes before pain sets in from lack of blood flow and pressure on the arm.
It’s the same with the wrist and thumb. Pressure and lack of fluidity between tendon and sheath cause pain.
Let’s get more technical on how De Quervain’s Tenosynovitis gets started.
The two tendons that insert on your thumb to make it wiggle come from the extensor pollicis brevis and the abductor pollicis longus.
Pollicis is just a fancy name for your thumb.
So in the old days when you could hitchhike legally, you used those two muscles and tendons to stick that (pollicis) thumb up nice and high!
Today, we keep our thumbs low while texting thousands of times a month. Or using the thumb-scroll on your computer mouse over and over.
That constant repetitive action causes a thickening of the tendons, which causes friction between the sheath and the tendon. The fluid (grease) that allows for gliding does not keep up, and the sheath feels it.
Over time, the pain will set in to try to get you to slow down. The nerves overreact, and motion on the thumb becomes unbearable.
That is DQ at its finest.
How do you know for sure if you might have De Quervain Tendinitis? Is there a test?
Yes! It’s called the Finklestein Test
To perform the test you tuck your thumb into all your other four fingers. You know you got it right when you cannot see your thumb or its finger nail.
Then pretend to swing a hammer down only using your wrist.
If you have pain at the bottom of the swing, you might have DQT.
For those who are visual like me I put the Finklestein Test in the video above.
Other signs you might have De Quervain Tendinitis or Tenosynovitis.
- Swelling in the “thenar eminence” of the palm.
- Pain when thumb is pulled
- Aching or throbbing in thumb at night
- Thumb locks up
- Difficulty pitching small things
- Pain when swinging a golf club
- Pain when shaking hands
These are some ideas that might signify having the condition or not. Always see your doctor to confirm the tests you did on your own for a true diagnosis.
I have worked on many patients with this condition and have witnessed great results just using massage and stretching.
Hope the video tips for massage professionals helps you – help your patients to better health.
Doug Holland, LMT
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