De Quervain's Tenosynovitis San Diego

De Quervain’s Tenosynovitis

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De Quervain’s tenosynovitis is a conditions that affects the tendons of the thumb. Pain in De Quervain’s tenosynovitis is often felt along the side/back side of thumb and the thumb side of the wrist. Grasping, pulling, typing, cell phone use, and other repetitive use of the hand can cause worsening symptoms in cases of De Quervain’s Syndrome. Watch our video below to learn more about De Quervain’s Syndrome and how we treat it in the office.

De Quervain’s/”Text Thumb” examination and treatment

Anatomy and Causes

When looking at your hand, extend the thumb back and look at the back of the thumb/wrist. You will see a few tendons stick up which create the borders of what is known as the anatomical snuff box. The bottom border of the snuff box is the abductor pollicis longus and the extensor pollicis brevis, the two tendons affected in De Quervain’s syndrome. Causes of De Quervain’s tenosynovitis are primarily due to overuse. Computer use, cell phone use are now leading causes for patients developing this type of wrist and thumb pain. Due to the amount of cases that are linked to cell phone use, DeQuervains is also known as, “Text Thumb”. The repetitive use of the thumb causes gradual tightening of the muscles which then causes increased friction along the bones/and tendons resulting in Dequervains tenosynovitis AKA text thumb.

A condition called intersection syndrome is another cause of wrist and forearm pain. This condition is similar to De Quervain’s but mainly affects the extensor muscles of the forearm. Some patients will have both conditions simultaneously as they are a byproduct of the same type of overuse. Luckily treatment options are the same for both intersection syndrome and De Quervain’ syndrome.

De Quervain's Tenosynovitis Treatment San Diego
De Quervain's Tenosynovitis San Diego

Treatment for De Quervain’s

Treatment for De Quervain’s Tenosynovitis is multifactorial. Graston Technique for De Quervain’s Tenosynovitis can help ease the pain and symptoms. Graston for dequervains syndrome may also help improve blood flow to the area which can help with improving the condition. Active Release Technique can help loosen the tight musculature that causes the condition. Ultimately, text thumb exercises are what will allow for long term resolution of the symptoms; the stronger and more resilient the muscles/tendons become, the less symptoms a patient will have.

Shockwave Therapy for De Quervain’s Syndrome

Shockwave therapy is a cutting edge treatment for chronic tendinopathies. It uses high energy sound waves, called shockwaves, to penetrate deeply into the tissues. This causes a pro-inflammatory effect which results in increased capillary formation, and decreased pain sensation. Most patients begin seeing improvement in De Quervain’s symptoms after the first shockwave treatment. Shockwave effects are amplified greatly when a series of treatments are performed, usually 1 per week for 4-6 weeks.

The effects of shockwave therapy for De Quervain’s are increased further when strengthening exercises are performed to the tendons. We tailor a specific strengthen plan for our patients to make sure they get the most out of their shockwave treatments.

If you are dealing with thumb, wrist, and or forearm pain.

Laptop ergonomics

Laptop Ergonomics | Recommendations

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Laptop Ergonomics: General Recommendations

Proper laptop ergonomics is very important for musculoskeletal health. We live a rapidly progressing digital age. More and more jobs are now performed part or full time remotely. Many people find themselves working from a number of different places and therefore primarily use a laptop.  Laptops are versatile and convenient; they also cause a high amount of physical strain on the body. It is very important to practice proper laptop ergonomics.

Laptops do not put a person’s body into a proper position. Due to the attached key board, small screen, and low height, most users find themselves with poor posture through their backs, neck, shoulders, and arms. At 40 to 80 hours per week, this will result in back, neck, shoulder, head, arm and wrist injury sooner or later. This article will discuss helpful recommendations for proper laptop ergonomics.

Laptop Stand

Goal: Raise laptop screen so eye level is in the upper half of screen when sitting/standing with upright posture.

Reason: Reduce Strain to upper back, shoulders, neck and head by promoting proper posture while working.

Equipment Recommendation: Adjustable Laptop Stand
One the most important elements for proper laptop ergonomics is to raise the laptop higher on the work surface. To accomplish this, use a laptop stand. We recommend a laptop stand that is foldable, light, and is adjustable to accommodate sitting and standing posture. The Adjustable Laptop Stand by Rhino Flex is a stand we recommend for patients who work at least part time from home.

We like this laptop stand for many different reasons. First, it is light and portable so it can be used on the go. You can set it up at home, coffee shops, office, you name it. Second, you can set it up to support a seated position and a standing position. For proper laptop ergonomics, having this ability is key to reduce strain to the body throughout the day. Finally, it has an adjustable leg system with measurements so you can quickly set it up and break it down between travel, seated, and standing positions; just remember the numbers!

Keyboard and Mouse

Goal: Keep arms closer to waist level and a slight downward bend at the elbow when screen is elevated.

Reason: Decrease strain to wrist, elbow, and shoulder.

Equipment: Logitech Bluetooth Keyboard and Mouse Combo
Most attached keyboards and mouse pads are again, terrible ergonomically. They often force your arms to work toward mid line and the mousing options (pad, stick, ball) are not as easy to use as a traditional mouse. Using a Bluetooth keyboard and mouse combo via a USB receiver on your laptop is the best way to go.

We recommend the Logitech Bluetooth Keyboard and Mouse Combo particularly when combined with a laptop stand. If you only use a laptop stand, then you will be forced to type like a T-Rex as the keyboard will be in front of your chest! This will eventually create issues with your arms, and posture. The mouse is a nice add on as the laptop mouse pads are not as efficient to use. Finally, having both the keyboard and mouse wireless is nice for on the go type of work and will help with proper positioning for your body.

Standing Mat

Goal: Improve cushioning on standing surface while offering different positions to stand in.

Reason: Decrease forces traveling up body from standing.

Equipment: Standing Desk Anti-Fatigue Mat

The last item that is recommended for proper laptop ergonomics is an anti-fatigue mat. Standing on firm surfaces for extended periods of time can cause discomfort to the main weight bearing joints of the body. We recommend a standing desk anti-fatigue mat to help disperse the forces traveling up the body. This particular mat works well as it also offers several different shapes, angles to stand on to further vary your position throughout the workday.

An important reminder for standing desks, vary your standing and seated position throughout the day! Many people transition to a standing desk and then stand all day long in the same position. Try different foot positions when standing, and work seated periodically throughout the day. Variety is key for proper laptop ergonomics.

Laptop Ergonomics: Conclusion

The combination of the above recommendations along with frequent mini breaks during the workday can help a lot with overall strain to the body. It is important to be aware of these fixes early on in your career to keep your body in the best shape possible. If you are suffering from posture related neck, back, head, and shoulder pain, we are happy to help! Our San Diego Chiropractors are conveniently located in Mission Valley. We are located near Downtown, Point Loma, Hillcrest, North Park, South Park, Golden Hill, and La Mesa. Our clinic also offers acupuncture, massage, and personally training. We believe in a well rounded approach to help a patient take the proper steps to optimal health. Schedule online or call our office at 619-818-4306.