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Better treatment for QUERVAINS TENOSINOVITIS with muscle pain.

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I have had de Quervains tenosinovitis (corroborated via US and Finkelsteins) since late Nov. BECAUSE:
1 PT gave me stretches and massage, no splinting (early Dec.)
1 nurse practitioner made the diagnosis and recommended a thumb spica (early Jan.)
1 (certified) doc gave laser therapy ans said a tendon needs to rest to recover
My son (mountain guide with biology, kinetics and a myriad of first aid and rescue training) agrees with above.
1 (my actual )GP suggested some splinting and stretching - conservative re: cortisone (no time for hnd specialist due to imminent travel) (now Feb.
Now in Austria (Feb. 16 to April 8)
Doctor here (did emerg knee surgery for husband last year) says this will never get better and that I need surgery to open the tendon sheathing..,rejects cortisone because of long term poor outcome...(now March)
Yet another therapist here recommends icing, stretching and no splinting. SO what I know is that no one really (I am actually going to get vulgar here) knows F--k about this. I am skiing and ski touring almost every day - no splinting...why bother.
Does ANYONE out there know ANYTHING about what might REALLY work here. I am an amateur athlete with considerable lay knowledge and diligent with any suggested therapies. I would be incredibly impressed and deeply grateful!


Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Mukesh Tiwari is online now

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Hello,
Thanks for your query at DoctorSpring.com
I have read your question carefully.
I feel sorry to know all about your feelings about your therapists.I want to let you know that if your diagnosis is correct then every therapist tried well to treat you.Towards conservative side de quervein disease is treated by rest ,steroid injection, physiotherapy modalities like TENS and others.these modalities should be tried at least for 6-8weeks to see their effects.
If any of these modalities unable to treat this condition then this is known as refractory de quervein disease.The treatment of this refractory condition is surgical release of tenosynovium or covering over the tendon.
At present my straight opinion towards your condition is to have steroid injection in tenosynovium with a senior orthopedic doctor and do rest in splint for 6weeks.If you do not have relief after then go for surgery.
Hope this all will help you
Regards


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
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