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Wrist Tenosynovitis and Complications from De Quervain release


(Canada)

About two years ago, I noticed that I was losing strength in my thumb which turned into moderate loss of use.

Over the course of two years, I saw several doctors, had an MRI, bone scan, xrays, nerve conductivity and was finally diagnosed with tenosynovitis.

I was in physio for a year and a half to no avail. When my wrist was manipulated, it put my forearm, elbow, tricep, bicep, neck, shoulder and back out.

If he worked on my upper body, it simply increased the pain in my wrist. I tried anti-inflamatory creams and pills (which I can't stand taking) and then finally had to resort to painkillers just to function.

I have an array of wrist/thumb splints, which never really worked. I finally found a plastic surgeron who agreed to meet with me and he attempted one cortisone injection, which only exacerbated my issues.

Surgery was scheduled and completed on January 29, 2010. I was told it would be approximately 2 week recovery and 4 months later, I'm only able to work 4 hours a day, I haven't been able to return to any of my activities, my symptoms have returned to presurgery status (with the exception of the pain level).

A bit of history....I have an office job where I type and write most of the day, having to flip through very large and heavy files and of course, it is my dominant hand. I am (or should say was) extremely physically active - since childhood - playing baseball, basketball, golf, volleyball, working out, yoga, etc. I was a gymnast in my childhood which may have also helped cause this issue (I am 38).

About 13 years ago, I broke both my elbows and both my wrists. In my left wrist, I broke my scaphoid and had no rehab following. That is where everyone started looking as it made sense that it may have not healed properly. It did.

The best anyone has ever told me is that the trauma from the break, coupled with all my activities, may have set this condition into motion.

Post surgery, my symptoms include radiating and burning pain into my thumb and wrist, bruising, swelling but only at the incision site which has never gone away, elbow pain, shoulder pain, forearm pain and neck pain.

I also can't put full pressure on my hand since the surgery. And my favorite part is that my wrist now looks "dented" and is nothing but skin and bones. I have lost muscle mass in my hand and have lost a great deal of strength on my left side. I did my course of physio and OT following the surgery but they claim they can do nothing more for me.

I will admit I'm not in as much pain as I was prior to the surgery but at the rate of deterioration I'm experiencing again, my guess is that it will be back shortly.

The surgeon is now talking about going back in as scar tissue may be constricting my tendons and/or my nerve. I went to my GP to discuss as the surgeon is a surgeon, and his idea of fix involves cutting.

I don't really want to undergo another surgery to start this process all over again but my GP said one more might help. He wouldn't recommend doing it again if it doesn't work. He has also suggested that I go to pain clinic which I am not in favour of at this point. I don't want to mask the symptoms, I want the the problem fixed and the symptoms gone.

Any thoughts, recommendations or ideas would be greatly appreciated as I don't to go through another 2 years of this. I want my life back!!!

Thanks very much!



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Joshua Answers:

Hi Canada.

That sounds horrible. I'm sorry your doctors have put you through that.

1. "one more might help" is not a good reason to ge a surgery, in my opinion. In fact, from a medical perspective it SHOULD not even be a reason. Hope and surgery don't really go together in this case.


2. I assume that you were in casts for the broken bones? Thus immobilized. Thus, connective tissue in the hand/wrist/arm shortened and shrunkwrapped. This makes structures TOO SHORT, and creates problems down the line.


3. Tendonitis is bad enough. Tenosynovitis, as I like to say, is a 'special' kind of problem. Read that page if you haven't already.

With your stuctures shortened down, every little movement is tugging on the painful areas, irritating them more and constantly.


4. What -exactly- did the surgery do? I imagine that it sliced into the tendon sheath. Of course there is scar tissue, that's what happens after surgery. Surgeons always seem surprised by this for some reason.

Is that scar tissue the problem now? Partly, yes, but it's unlikely that that's the only reason you're still in pain. The factors that caused the problem in the first place never got dealt with, surgery certainly doesn't deal with them.


5. You are stuck in a HUGE Process of Inflammation. Make sure to read that page, if you haven't.


6. From a self care perspective, I suggest that you get my Reversing Wrist Tendonitis ebook. Drop me a note when you do, I'll also send you the Quick Start Guide ebook that comes with my Carpal Tunnel DVD, there's a couple things in there that would be useful for you.

It contains much of what you need, and a plan of attack. You need to deal with the entire arm structure, the inflmmation, some HIGHLY likely nutritional deficiency/insufficiency, and the too tight connective tissue issue.



7. Regardless of the actual structural state right now, neurologically, you're stuck in a defensive, protective response, which ironically maintains and worsens the pain and problem.


8. I agree with you on the 'fix the problem' philosophy. It's going to take some time and work on your part, but in my experience, that's really your only 'good' option.


9. When you get the ebook, drop me a note and keep in touch with me, I'll help guide you through the self care and the getting better process.




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Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.
And, comments have a 3,000 character limit so you may have to comment twice.
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for
Wrist Tenosynovitis and Complications from De Quervain release

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Jun 14, 2010
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PART 2 - Reply and further comments - Wrist Tenosynovitis and Complications from De Quervain release
by: Anonymous

Thank you so much for your response Joshua. Much of what you've said makes so much sense and I can't figure out why no one is working with me to fix the problem. I'm not fixed, yet no one but me seems to be looking for the next step. In my opinion, everyone has had tunnelvision, in that I don't seem to have fallen in the "normal" scope of recovery, meaning they have done what is typical but I'm still not fixed and no one is looking outside the box for a solution.

I agree that going for another surgery doesn't seem very logical if my surgeon isn't certain. It does make sense to me that scar tissue might be part of the problem, but massage can help get rid of it and so can ultrasound. I understand that even the smallest amount of scar tissue might affect this because it is such a small area but am not sold on another surgery.

Yes, when I broke my wrists/elbows I was in a cast for about 3 1/2 months. I was always fearful that I would have problems due to no rehab following that. If this started my problem, then I guess it has come in spades!

As for the surgery, yes he did cut the sheath. All I know is he told me that he wasn't surprised I was having all the problems because it was really tight when he went in. His comments made me feel better because I felt that the surgery might actually work. Sadly, I was wrong.

I have read pretty much your entire site and I will pick up your book as well. I am also in the process of attempting massage again to try to deal with the tight muscles/scar tissue and lots and lots of icing. Hopefully, this will help in the meantime and can start doing some strengthing exercises. I will also go back to my GP and have some blood work done. I wouldn't think nutrition would be a problem but I guess there could be some deficiencies - I don't take any supplements and I don't really eat a whole lot of meat (although I do eat protein in other forms).

I'm not afraid of hard work and I was expecting a long recovery (after being down for so long). It just seems futile right now because for every step I take forward, I take 12 back. I do things daily with the thought of "how much am I going to regret this later". Not a way to live, and am getting very tired of being consumed by this!!

Thank you again for your insight and will be back in touch once I have read your book.

Canada



Jun 14, 2010
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PART 3 - Wrist Tenosynovitis and Complications from De Quervain release
by: The Tendonitis Expert

Joshua Comments:

Great.

1. I hear what you're saying about 1 step forward, 12 steps back. And, I assert that you will be pleased when you start taking actual steps forward down the RIGHT path.

2. Don't discount nutrition.

3. Yes, your tendon sheath was tight. (Of course it was!) Unfortunately, cutting it doesn't necessarily make it less tight, and it certainly does not deal with the reasons that it was tight in the first place (inflammation and irritation).

4. Good news/bad news. MANY people hit this point, where they've gone as far as the medical world can take them. At that point it becomes a quest, a trek, to find the right information that you can use to fix yourself.

Not necessarily easy, but absolutely doable.


Hang in there.

Keep me updated.




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