Although identified at the end of the 19th century, this over-use-related tendon inflammation may just be the condition of our era.

 

Clinical Picture

We’ve all been there. It’s that burning sensation after a 12-hour fortnight stretch, the aching after an SMS showdown with your S.O., or that weakness you suddenly feel when putting your baby down after four hours of bouncing, rocking, and swinging them to sleep. These symptoms are very likely linked to the thickening and inflammation of the soft tissue enveloping the tendon of your thumb-extending muscles. This condition is called de Quervain’s tenosynovitis, or more commonly, texter’s thumb. Symptoms include a burning or cramping pain at the base of the thumb/wrist and possible dysesthesias such as numbness and tingling.

According to medical literal, the cause of De Quervain’s tenosynovitis can be either acute trauma or a recurrent, irregular action or exercise, resulting in cumulative microtrauma. Therefore, individuals who use their thumbs repetitively are more likely to develop the condition.

In a study observing the texting habits of university students, researchers found that students who send more than 50 SMS a day, tended to develop pain over the base of their thumb. They concluded that due to the nature of phone keypads and their high texting speeds, excessive texting may result in de Quervain’s tenosynovitis. The researchers of this study recommended cellphone users to text with both hands, take breaks, slow down their texting speeds and properly support their forearms and backs while texting.

Treatmenttexting thumb

Conservative treatment of the condition may include anti-inflammatory drugs, corticosteroid injections, and manual therapy. If symptoms are not resolved over a few weeks following conservative management, your caregiver may recommend surgery to release the tendons from the effected compartment. Subsequent therapy will include patient education, splinting exercises, and management of swelling and the surgical scar.

The following are recommended exercises for managing de Quervain’s tenosynovitis. These exercises should be performed after a 2 to 3-week period of splinting, cold pack therapy, and the reduction of aggravating factors (texting, drawing, wringing, etc.). Once you feel more confident in moving your thumb, these exercises can help in conditioning your muscles and supporting tissues for better movement.

thumb exercises

Exercises:

1) Wrist Strengthing 

  • Place elastic band (or bungee cord) underfoot and hold other end with the affected hand
  • Fixated forearm on your thigh or another surface; only your wrist should be moving up and down
  • Pull the affected hand up with your other hand against the band’s resistance
  • Slowly lower your wrist towards the ground; do not allow the band to pull you but rather slowly lead the band downwards
  • Repeat 15 times, twice a day.

2) Wrist Stretch 

  • Place wrist, palm upward on a surface
  • Turn your body away such that your fingers are pointing the opposite direction.
  • To increase the stretch, turn head to the side opposite of the hand on the surface.
  • Hold for 10 seconds, release and repeat 3-6 times.

3) Thumb Stretch 

  • Place affected hand, palm down on a surface.
  • With your other hand gently pull your thumb away from the surface.
  • Slowly return your thumb to the surface.
  • Repeat 5-10 times every 2 hours.

4) Pulling Stretch

  • Place your hand perpendicular to the surface.
  • With your unaffected hand gently pull your affected thumb away from the other fingers.
  • Slowly lower your thumb back down.
  • Repeat 5-10 times every 2 hours.

 

 

When dealing with over-use tendon inflammation, the name of the game is relative rest and working smarter with your body to prevent chronic pain. Obviously cutting out texting cold-turkey is an absurd and unrealistic expectation in this day and age. We can’t pretend that phones are going anywhere anytime soon. So, we’re forced to learn to live together in harmony. But hey, maybe try voice notes instead?