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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.

Debunked Workstation Myths

Debunked Workstation Myths

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There are many commonly accepted guidelines for a safe and comfortable workstation that are actually myths. Some postures and furniture can actually harm you and lead to discomfort, if rigidly followed. These debunked workstation myths will help you to manage the health risks of your home or work office:

 

Debunked Workstation Myths

 

Myth #1: Sitting correctly at a desk will eliminate discomfort and reduce injuries.

Debunked Workstation MythsIn actuality, sitting with picture-perfect posture for long periods of time can actually lead to more discomfort, as it is extremely fatiguing. It can also lead to joint-pain and muscle strain because the torso is placing constant pressure on the lower disks in your back. Even in the ergonomically correct position, your arms and hands can still incur injuries. Any time you are sitting or standing in a static position, you increase the risk of prolonged physical conditions. To avoid any injuries at your workstation, try alternating between sitting and standing while working. Choose dynamic positions that will increase blood flow and alleviate stiff muscles. Also, include small rest breaks and stretch frequently to help avoid injuries.

 

Myth #2: Always sit upright, and never recline at the workstation.

4 out of 5 workers would prefer to recline their chair slightly when working. In fact, a reclined position creates much less fatigue than sitting upright. Being slightly reclined is also much easier to maintain and alleviates gravitational pressure on the lower disks in the back. However, be cautious to avoid slouching, which can cause injuries from a lack of sufficient back support.

 

Myth #3: Ergonomic chairs are one-size fits all.

A single chair size won’t fit every shape and size. Women are shaped differently than men, and their hips are generally wider. Men usually have longer legs and consequently will need a deeper seat. There are many different body types, and each one requires a different seating solution. In addition, different chairs are appropriate for different tasks. When selecting an ergonomic chair, consider the tasks you will be doing and your body size and shape.

 

Myth #4: Adjust the chair height according to the table height.

Unfortunately, this is not always the case. Although it may seem like a simple solution, this does not always result in a safe sitting position. Instead, keep your chair at the appropriately adjusted position for your body type. If your chair is too low, it can add extra pressure to your legs and back. If the chair is set too high, it can result in discomfort from your feet dangling. You can get a footrest to avoid this, but the best way to avoid injuries is to adjust the table height or the task at hand.

Many people don’t realize that these commonly believed workstation postures are in fact myths. By educating yourself with the above recommendations, you can avoid unnecessary workstation injuries and added discomfort.

Selecting The Best Office Chair

Selecting the Best Office Chair

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Not all chairs fit all body types. When selecting the best office chair for your workstation, there are a few different factors that you should keep in mind. When sitting in a chair, your back will be most comfortable in a slightly reclined and neutral position. Each element of the chair should help you maintain this neutral position.

What To Look For When Selecting the Best Office Chair

 

Seat

Selecting The Best Office ChairThe key to choosing the right chair is the ability to adjust the seat depth, height, and tilt. Choose a seat depth that supports your hips and legs, and look for a chair with sliding seat options. There should be a 1-2” space between the back of your knees and the front of the seat. The height of the chair needs to adjust according to your height. Your feet should be flat on the ground when your hips are pushed to the back of the seat, and you should be able to tilt the chair back to recline or sit upright. A reclining mechanism can also help with increasing movement while working.

Backrest

Back support is very important when selecting an ergonomic chair. The chair should provide lumbar support for your lower back. If this is missing, it can lead to slouching and strain on the back. The back of the chair should allow for height and angle adjustments. The contour of the backrest should allow for free arm movements while still supporting the upper and lower back. If you tend to recline often, you may need a backrest that supports your shoulders and neck. The angle of the backrest should adjust independently from the seat at a 100° to a 110° angle.

 

Armrests

When your shoulders are relaxed, your forearms should be able to rest on the armrests fully and comfortably. Adjust the armrest inward or outward to affect the width based on your stature. Armrests can support your upper back when taking breaks from typing.
A single chair or adjustment may not be applicable for all tasks, so you may need to experiment with different chairs or adjustments. The goal of an ergonomic chair is to provide you with the comfort and support your body needs.

Ergonomic Desk Guide

Your Guide to a Fully Ergonomic Workstation

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If you spend a lot of time sitting at your work desk, it can actually cause some serious health issues if the workstation is not set up properly. Here are some easy adjustments you can make to ensure that you will maintain a healthy posture at an ergonomic workstation.

This is your guide to a fully ergonomic workstation:

 

Chair

Ergonomic Desk Guide

  • Sit on your chair with your hips completely pushed to the back of the seat.
  • Adjust your chair height so that your feet are flat on the ground.
  • Your knees should be level to your hips or slightly lower than your hips.
  • Recline the back of the chair so that it is at a 100°-110° angle.
  • Support your lower back with a by using an inflatable cushion or a small pillow for extra support. You can also add on a lumbar support to your chair.
  • Set the arm rests at a height where your shoulders are able to relax comfortably on them. Another option is to remove the arm rests altogether.

 

Keyboard

  • Position the keyboard so that it is directly in front of you and centered with your body.
  • Sit closely to your keyboard to avoid overreaching.
  • While your shoulders are relaxed, position the keyboard so that your arms are at a 100° angle. Ensure that your wrists and hands are straight.
  • If you need to tilt your keyboard up, make sure that your chair reclines so that you are still at a 100° angle.
  • If you’d like to use a palm support, make sure that you don’t let your palms rest on it while typing, as this is not recommended. Additionally, try to keep your wrists slightly elevated when typing.
  • Keep your mouse as close as you can to the keyboard. It should also be at the same level as the keyboard.
  • If you need to adjust your seat height to accommodate the keyboard, keep a footrest under your desk for your feet to rest on. This way your feet will not be left dangling.

 

Computer Monitor

  • Adjust the monitor to keep your head in a neutral position when working.
  • The top of the monitor should be around 2 to 3 inches higher than eye-level when seated.
  • Your screen should be at least an arms length away.
  • Reduce glare and reflections on your computer screen by adjusting the monitor’s positioning.
  • If you are using a laptop, place it on an adjustable stand, and use an external keyboard and mouse.

 

Phone

  • Keep your phone as close to you as possible.
  • Wear a headset when possible to avoid holding the handset with your shoulder.

 

In addition to these guidelines, try to avoid slouching and leaning as much as possible, and don’t forget to take 1-2 minute breaks to stretch every 20-30 minutes. No matter how ergonomically correct your workstation is, sitting for prolonged period of time in a static position can significantly decrease blood circulation which can lead to other health risks. Take the time to set up your workstation the right way. By following this quick guide to a fully ergonomic workstation, you will be able to work safely and comfortably.

Ergonomic Chair Setup

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Comfortable desk work begins with proper chair setup. Follow these helpful tips to ensure a proper ergonomic chair setup.

Chair Setup

  • Push your hips as far back as they can go in the chair.
  • Adjust the seat height so your feet are flat on the floor and your knees are equal to, or slightly lower than, your hips.
  • Sometimes the desk height forces you to have the chair higher than you what will allow you to touch the ground.  If your feet don’t reach the ground put a small box under your desk to rest your feet on.
  • The back of the chair should be at a 100°-110° reclined angle which should create an angle between your body and your thighs of 90° -100°.

    Step 1 Chair.

    From UCLA Ergonomics

  • Make sure your upper and lower back are supported. Use extra cushions at the small of your back if your chair does not have adequate support.
  • Adjust the armrests so that your shoulders are down and relaxed.
  • If your armrests prevent your shoulders from being in a relaxed position, remove them.
  • Keep your body straight with the head and neck upright and looking forward, not to the side. Do not hunch over or slouch.

OTHER TIPS

  • Don’t cross your legs while sitting. This can cut off circulation and/or lead to hip problems.
  • Make sure your chair seat has a soft, downward curved edge so that it does not dig into the back of your thighs. This can also cut off circulation.
  • When purchasing a chair the best feature is its ability to adjust each component separately.
  • If sitting is too painful, consider a standing workstation.

 

Next post “Ergonomic Keyboard and Mouse Setup”