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-inflammatory 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 surgeon 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 pre-surgery 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.

See: What Is Tendonitis?

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 program. 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 inflammation, 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






Reversing Wrist Tendonitis ebook cover


Reversing DeQuervain’s ebook cover


Carpal Tunnel Treatment That Works Dvd cover

Reversing Guitar Tendonitis ebook cover







Comments for Wrist Tenosynovitis and Complications from De Quervain release

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Jun 14, 2010
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starstarstarstarstar 		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
Rating
starstarstarstarstar 		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.



Jul 21, 2011
Rating
starstarstarstarstar 		Update
by: Canada

Well, it's been over a year now and I thought I would give you another update.

Unfortunately, I'm still having major issues up my entire arm, shoulder and neck. I still go for massage twice a week and have been for a year. I attempted to do the necessary stretching and slow rebuild with absolutely no success - the more I did, the more I needed a massage, the better I felt, the more I did, and so on. I decided out of nothing but frustration that I would just go back to my normal activities and suck it up. And of course, that just didn't work.

I finally decided to give in and go to pain clinic to get help in managing the pain. Instead of merely prescribing medication and/or acupuncture, the doctor at the pain clinic has been great - he's a puzzle solver. I got blood work done and found that I was B12, D and iron deficient - which of course isn't good for healing. So that is being addressed. I have also been told that I have joint hypermobility - which I'm amazed no one has ever told me - and which explains why up until this point everyone thought my range of motion was great and wasn't taking my complaints all that seriously. So he sent me to a hand therapy clinic and wants me to see a physio for my joints. My hand therapist and regular physiotherapist are now working together. And the latest is that it looks like it might have been radial tunnell syndrome all along. Not that the de quervain's didn't exist, but probably came up due to the radial tunnell syndrome.

The hand therapist is hopeful that treatment will help (at this point, heat, massage, stretching and ultra sound) for the radial tunnell. If my forearm muscles can calm down, it might alleviate the pain in my hand, elbow and shoulder. If not, I'm afraid another surgery is in my future.

I'm wondering if you have any words of wisdom I might now take to the doctor and/or either therapist with these new developments. Any insight is greatly appreciated as another surgery - even though it would be on my elbow - isn't high on my "to do" list after the colossal failure of the last one!!

Thanks!


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Joshua Comments:

Hey Canada.

A bit late on the response here....

1. Yes, I can't enough stress the nutrition side of things. YOu're body literally can't work properly without enough Vit D, B12, magnesim, etc.

2. Is your Vit D level up between 50-80 ng/ml now? Were you taking Vit D3 or prescription Vit D2?

3. How much B12 have you been taking? How much magnesium? How much B6?

4. Give me an update on what's happened since July.
Mar 19, 2012
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starstarstarstarstar 		Update...
by: Anonymous

Hey Joshua,

Here's the latest in this pathetic saga of trying to determine what is wrong with me....

First off, I was never taking perscription vitamins with the exception of the iron and b12. I had one iron injection as well as a couple B12 injections. Outside of that, just over the counter iron, b12 and D (2,000 mcg), which I'm still taking. And I have never been told to take anything else.

I am not in hand therapy any longer because it was merely causing me pain. I am also not in physio any longer for my shoulder and neck, as the more nerve gildes I did, the more pain I was in.

I am full on in pain clinic. Taking 600 mg 3x a day of gaba and having nerve blocks. The gaba, as far I'm concerned isn't working and I want to stop taking it. The nerve blocks are fantastic for my forearm, elbow, bicep, tricip, shoulder, peck and neck pain. They only work for a short time (the last one lastest about a month - so that was fantastic) but do absolutely nothing for my wrist/thumb. I'm about to start my next set of nerve blocks, but is supposed to be more direct this time (as opposed to just above the elbow). I'm set to see a physiatrist at pain clinic and am hopeful that he can stop this cycle. They are looking at some trigger point in/near my pec as the possible cause. Although I don't really understand that because they've "determined" the issue is somewhere between my elbow and wrist.

I'm still in fight mode and not prepared to give up. Pain clinic is supposed to give me back my quality of life. Just because I can work full time doesn't mean I have any quality of life. After an 8 hour day, I have a 2 hour ritual of ice and heat. I can't hold my toothbrush or wash my hair without pain. I can't sign a letter or write a cheque without being in pain. I can't hold a fork or spoon without pain. I can't play sports or work out without being in pain. I don't sleep through the night. Pain clinic is supposed to manage pain, no? I am, so far, disappointed with the results of pain clinic. I am not prepared to be on meds with no result. I'm hopeful that these nerve blocks will do something for me because they relieve so much of the arm pain but should I not be doing something for the wrist pain while these nerve blocks are working? or should I not be working on something because the block will allow me to do so? Is pain clinic only there to relieve pain? Should I not be getting some direction about dealing with everything else? I'm still trying to figure this process out...

Here's hoping year 5 finds the solution!!!

Thanks again for all the insight over the last couple of years. It has given me many questions to bring to the docs over time.
Mar 19, 2012
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starstarstarstarstar 		Hey Canada. Time To Look Deeper
by: The Tendonitis Expert

Joshua Comments:

Hey Canada.

When you say 'I'm not prepared to give up', that totally puts me on your side.

Ok, so. Over time, you've done what I've told you to do.

Here's what I think you should do now. I think you should talk with my Kerri from www.Easy-Immune-Health.com

Kerri deals with the systemic side of things. A phone consult may be involved, but she'll suggest a couple tests for you (You're in Canada, as I recall, and I don't know what that means for testing and the labs she works with.)

At the very least, she'll have some insight on where to look and what to have your doctors look for. Nerve blocks are fine to get you through the day, but there's no 'fix' there at the pain clinic, it seems.

It's not my field, but from watching over Kerri's shoulder, there's a few things that can be at play in your body's inability to heal/recover/get out of the pain dynamic you're stuck in:

* adrenal fatigue
* various markers of inflammation
* cortisol imbalance
* various hormonal issues
* a variety of possible specific nutrient deficiency.

The labs she uses look for things the hospital industry doesn't bother to look for (which is a shame).

Your body is stuck in a serious pain dynamic, and it can't get out of it. Because something is missing, and/or something is off kilter.

There's only a couple people that I know of that are better than Kerri to talk to about that, and they're the people that taught her.
Mar 20, 2012
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starstarstarstarstar 		Joshua asked me to comment
by: Kerri Knox, RN- The Immune Queen!

Hi Canada,

Joshua asked me to comment on this thread. After reading of your situation, and especially your last comment, you should definitely consider that you are most likely Gluten Intolerant. When someone has multiple nutrient deficiencies, it's almost certainly the cause, and one that doctors will almost never delve into unless you have chronic abdominal pain, fat in your stool or other extremely obvious gastrointestinal symptoms.

However, gluten sensitivity can and has caused ONLY symptoms similar to yours without having ANY digestive symptoms whatsoever; a fact that doctors just simply are not aware of and do not even BELIEVE in in most cases, despite their being thousands of studies on this.

I would highly suggest that you reconsider your entire diet, get off of gluten and take a look at the book The Healthy Urban Kitchen and follow the dietary recommendations that they make.

This may not solve your problems, but I think that you will essentially be unable to solve your health issues without drastic changes in your diet and your overall nutritional status. And, like Joshua said, get your vitamin d levels to the OPTIMAL levels of between 50 to 80 ng/ml and get on high dose magnesium and Methylcobalamin B12, not just 'B12', but methylcobalamin.

Also, most people think, "Oh, my doctor tested me and I came back deficient in these nutrients." But think about it, he ONLY tested you for 3 nutrients and you came back deficient in all three! Yipes! I am nearly positive that he didn't test your Omega 3 fatty acid levels, your zinc levels, your carnitine levels, your Vitamin B6 levels, selenium, copper, vitamin E, Vitamin K, etc. etc. So, if he tested 3 and you are deficient in 3, what other nutrients are you deficient in? My guess would be probably a lot more- it's just that no one is testing you for those other ones. Which is why I suspect that you are gluten sensitive and why I suggest an entire revamp of your diet- and likely your views and beliefs on what constitutes a 'good' diet as well.

Sincerely,

Kerri Knox, RN
Mar 20, 2012
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starstarstarstarstar 		Joshua Comments on nutritional issues
by: The Tendonitis Expert

Thanks Kerri.

Canada, as I recall we've talked before re: gluten, and as I recall you'd gone off gluten for periods of time.

Kerri's last paragraph was the main reason I suggested you talk with her: if you're missing certain nutrients, even if you go off gluten, if your body doesn't have what it needs to heal/repair/get back to balance, it can't.

And if nobody looks in the right places, in the right way....the methods/prescriptions can't/won't help. Which seems to have been the case so far.

If Kerri can't work with you for certain tests (as you're in Canada and I don't think she can, though maybe), it's still worth a phone consult with her to get your doctors to test for the right things, with the right tests.
Mar 22, 2012
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starstarstarstarstar 		Thank you
by: Anonymous

Joshua/Kerri

That's an interesting idea - however, the question that I raise, is if I have a gluetin intolerance, why is it only localized in my arm? For instance, during this saga, I badly sprained by ankle. That healed fine and quickly. No issues.

Why then would I think that I have an intolence to gluetin which is ONLY affecting my hand and arm. Could it not simply be that the surgery wasn't successful and due to the ability to use my hand, my arm simply deteriorated.

As for my diet, I consider myself to be a healthy eater. I have added meat back into my diet (however, red meat is only be eaten maybe twice a month); I eat a lot of pork, tuna and salmon (and not canned). I still do eat a lot of Tofu as well.

I eat as many organic fruits and veggies as I can. And I am very cognizant of not eating foods high in perservatives. But, I do admit, I am a major carb loader - bread, pasta, rice being the big 3. I also admit that I have only two meals a day and I'm not a big snacker - which I know is not a good thing and which could certainly cause nutrient deficiencies I suppose.

I will check out the The Healthy Urban Kitchen and will talk to my doc about being tested for other nutrients. I will up my D and get on the methylcobalamin B12.

I am will to try anything to help end this pain!

However I am a little skeptical that diet is the issue with me. I believe that the tenosynovitis has returned and I have some sort of nerve issue in my arm. Maybe the diet will assist with the nerves.

Thanks again for all the insight. You've been fabulous! I'll let you know what happens from this!



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Joshua Comments:

It may not be diet. I/we're not claiming that with 100% certainty. But we are saying that gluten is very often a HUGE factor in chronic pain situations.

Having said that, if you're a major carb loader (bread = gluten pasta = gluten) AND -if- you are gluten intolerant, and -if- you have long term down sides from the inflammatory nature of gluten (see: Leaky Gut), then it's very possible and likely that gluten is playing a role here.
Mar 24, 2012
Rating
starstarstarstarstar 		Joshua Responds - Canada - Wrist Tenosynovitis and Complications from De Quervain release
by: The Tendonitis Expert


Gluten is inflammatory. The body has to respond to it, and it usually responds poorly. Gluten intolerance results in nutritional deficiency, for a variety of reasons.

Can the negative factors of gluten intolerance result in pain in just one location? Yes.

Why? Just because that's how it works out sometimes. Every body is different, and odd/unexpected side effects happen sometimes. Frequently, actually.

Can it be as simple as that you have a problem in that limb? Certainly. But you've been hurting, and hurting significantly, for a good long time, as I recall.

That means that you either need to do the self care that's in my ebooks and DVD's, and/or it means that there's a systemic issue(s) that needs to be dealt with before you body can actually have a chance to heal.

Nerve problem? Nutritional issues cause nerve problems. So does too tight muscles and too tight connective tissue.

Pain problem? Nutritional issues cause/help cause pain problems. So does too tight muscles and too tight connective tissue.

Post Surgery Pain problem? Nutritional issues cause/help cause pain problems. So does too tight muscles and too tight connective tissue.

Maybe you're -just- jacked up from the surgery....but you had factors that drove you to surgery...and surgery does NOT fix the CAUSE of the problems that drive people to surgery.

So since you've been hurting a lot for a long time, and the self care you've done hasn't help much at all, then we have to start looking at 'deeper' factors.
May 22, 2012
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starstarstarstarstar 		I too am from Canada
by: Canada TWO

I too am from Canada. I could have been reading about myself in 'Canada's' comments!!! - I have been struggling with tenosynovitis for 1 year, and succumbed to de Quervain release surgery 3 weeks ago.

I am in greater pain now than before the surgery.

All doctor's seem to have given up on me, saying I should be 'problem free now that I am post-surgery'. This is so wrong!

I have had a terrible intuitive feeling about this syndrome all along, and fully regret having the surgery - I feel my hand will never be normal again. This brings on severe emotional depression along with the physical pain and lack of mobility.

This past year has been hell. I am right handed, and my right hand is afflicted. I was always very active and busy, since the onset of my problems, my life has virtually come to a complete halt.

Any encouragement, solutions, advice would be much appreciated.


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Joshua Comments:

Hi CTwo.

Yep, tenosynovitis is no fun. Surgery can make it much less fun.

I wouldn't go the direction of 'I'll never get better'. If the surgery didn't damage a nerve and a huge amount of scar tissue didn't get created, you can very likely still get back towards normal.

Start with what's in this thread, and let's go form there.
May 23, 2012
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starstarstarstarstar 		de quervains post surgery
by: Canada Two

wow! someone is listening! thank you so much for the feedback. I am currently trying to convince Dr's and insurance that I require physio and/or occupational therapy (3 weeks since surgery).

When have I 'passed the point of no return' with therapy?


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Joshua Comments:

What do you mean with that last question. And/or, define 'point of no return with therapy'.
May 23, 2012
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starstarstarstarstar 		de quervain release when is it too late to start physical or occupational therapy?
by: CanTwo

Is there a point post-surgery when it is no longer viable to undertake physio or occupational therapy? I feel I should have begun physio perhaps 2-3 weeks after surgery, and am afraid now that after 4-5 weeks post surgery physio may not have any positive affect.



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Joshua Comments:

It's never too late to start therapy. When you start definitely does change the game, of course.

It also just all depends on how skilled/educated the therapist is and if they have any chance of helping your, in the first place.

But yes, get into therapy, at this point sooner is better than later.
May 31, 2012
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starstarstarstarstar 		Comment to Canada 2 and Update
by: Anonymous

Let me first say to Canada 2, don't give up. I was told after surgery, it would be a 2 week recovery (3 at the longest); 8 months later I returned to work. Don't rush your recovery from surgery and continue with any form of therapy available to you. In my case, I don't believe anyone took into account the 3 years of deterioration leading up to the surgery & no one has ever addressed the potential cause of the tenosynovitis in the first place. 3 years later, I'm still suffering & still attempting everything & anything to find a cause which will result in a fix which will lead to relief. FYI, there is a highly regarded hand clinic in London, Ontario which I am desperately trying to get a referral to, but that's not my province, so the games continue. I've got to find something before my thumb & index finger stop working completely. Our medical system sucks and you just have to continuing battling through!

That being said, I've now gone gluetin free for the last two months & have to admit I don't see a difference at all. (I have a friend with celiac's & was given a crash course.) With that, I’m still in pain, unable to do most daily activities at work or home without causing more pain & now being even more miserable by not being able to eat the foods I enjoy or have the odd beer with friends. None of the plethora of doctors I'm seeing believe gluetin intolerance could be a contributing factor & not one is willing to do any tests. I'm not sure I want to continue on the gluetin free path but haven't decided.

Also, the physiatrist has confirmed that I have surgical nerve damage. Not sure how this diagnosis has come to fruition as I haven’t gone for any further testing. The last I was told was that I have a "slowing in the function of the radial nerve, but that doesn't equate to nerve damage". With the nerve damage, I was told that it would never recover. All they can now do is try & help with the nerve pain (gaba & nerve blocks). Then they can address the trigger points (of which I have 5), but that won't happen until they figure out what helps the nerve pain.

Now, with my latest diagnosis (which continues to change with every new doctor), should I not be seeing a neurologist in order to determine how to go forward with "nerve damage"? Or is nerve damage merely nerve damage & sucks to me? Also, if I have 5 trigger points, do those not need to be treated? Is this not a separate issue? Lastly, if I have surgical nerve damage, why is my thumb & wrist in the exact same level of pain as it was prior to surgery? That, to my logic is impossible…unless of course, I don't have nerve damage; my radial nerve is still compressed somewhere, which compression is causing the pain, which pain has caused the trigger points, all of which now taken together exacerbate the pain and mobility in the thumb & wrist. Have I not now come full circle & am back to the beginning of this saga?
May 31, 2012
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starstarstarstarstar 		Comment to Canada 2
by: Anonymous

Oh ya, and I forgot the most important thing, DO NOT let these doctors tell you you're depressed. This is a very frustrating journey - and you will get down - but dust yourself off and keep going. They will (or even may have) tell you you're depressed and will want to treat that. I seem to have that battle with every 3rd doc I see. If I'm down or angry when I see a doc, it's always depression that is the cause, not the fact that I'm in pain and have been for 5 years. It's not in my head and it's not depression. Fix my problem and I'd be happy as a clam!
Jun 03, 2012
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starstarstarstarstar 		post de quervain's release
by: Canada Two

Dear Josh, how I wish I would have found your website prior to having had surgery!!!!! 5 weeks post-surgery, and still in more pain than before. I am going to start your recommended process of dip-icing tomorrow as the surgeon tells me I still have considerable inflammation. Would it be prudent to also be wearing my wrist splint at night? I find your site SO informative and helpful, you are a godsend! thank you!

Dear Anonymous (canada?), Thanks for your response also. I have heard of the hand clinic in Ontario - I am from Quebec, so suppose I would not be able to access it either. I feel very let down by the healthcare system as no one really seems to know what they are dealing with, nor are they willing to look further into it. The greatest help and concern I have received thus far is from my previous ergotherapist, Murielle. And of course this site! Just wish I had come upon it before having had surgery. I am also having to deal with CSST (workers comp) which just adds a whole other element of frustration and discouragement to this already frustrating and painful process. Like you however, I will not let this defeat me! I continue to follow the good words of Josh, as he seems more educated on tendinitis issues and makes more sense than anyone else. Good luck!
Nov 20, 2012
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starstarstarstarstar 		Been in physiotherapy & had acupuncture
by: Loves 2 golf

I've been suffering with a DeQuervain's tenosinovitis since last March. From April to August, I've been in physiotherapy & have had acupuncture twice a week. They've both helped a bit.

Then I had a cortisone injection & was suggested to start physio at a different sports clinic & have acupuncture done by this physiotherapist. BIG MISTAKE ! It's made my wrist worst. My family doctor is now referring me to an orthopedic surgeon. I've checked his credentials & patient comments online: all positive feedbacks & pleased patients. Nevertheless, no one has commented on tenosynovitis post operation which I think I will need .

After reading the comments here, I wonder if I should go ahead with the surgery if it is recommended by the doctor. Is it possible to have the London Ontario doctor's name please.

I also am having problems with WSIB. Talk about having these people treat you like a liar when they are the liars. They have the gift of gab and the ability to twist and turn everything you say into some far fetched reason for them not help you get better.

My question ? Should I opt for the surgery ?

Thanks for your replies.

Loves 2 golf


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Joshua Comments:

Hi Loves2Golf.

I certainly can't advise you to get the surgery or not.

Personally, I don't think it's the best idea, as it in no way deals with the CAUSE of the problem. Maybe it'll get you out of pain for some amount of time, maybe not.

I'll have the Reversing Dequervain's Tendonitis ebook done in a week or so. Until then, you might want to get Reversing Wrist Tendonitis and start working with it, then email me in 1-2 weeks and I'll send you a copy of the Dequervain's ebook.

If there's tenosynovitis involved, that just means the tissue is SO aggravated and inflammed that it'll take a bit more time and patience and care.

Ask your surgeons WHY you're having pain and what exactly surgery does that will fix it forever.

See: Quiz Your Doc
Nov 22, 2012
Rating
starstarstarstarstar 		post de quervain's release
by: Canada2

It is 6 months post-surgery, and I still have problems with my hand. I do believe the surgery alleviated the swelling and inflammation for the most part. However, I have less mobility now than before the surgery!! and have chronic underlying pain. I am under the impression that the doctors just "go to" the most common and easiest solution, without looking at all of the facts. Was surgery the answer?? - not really sure....
Nov 29, 2012
Rating
starstarstarstarstar 		I get where you all are coming from
by: California

I am 3 months post op for carpal tunnel and de quervain's release. The carpal tunnel surgery seems to have helped, but I still suffer from the tenosynovitis at the base of my thumb.

I had the surgery on one wrist, but both are hurting equally the same now. I am also very discouraged and getting the run around from physicians, surgeons, and physical therapists.

I have very reduced mobility in the wrist that had surgery. Nobody can figure out why I'm not better.

I've also been told I have this circle of pain thing where I am unable to relax and let it heal possibly due to "over active nerves?" I have been out of work for 7 months now and got layed off just after the surgery.

I can't imagine returning to work with the pain I have, but I need to survive somehow. There has to be relief out there somewhere!


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Joshua Comments:

Hi California.

You said "Nobody can figure out why I'm not better."

With all due respect to the professionals you've been working with, that's because A. the people you've been working with don't know why you're really hurting in the first place, and B. they somehow believe that surgery will magically fix everything.

There's an element of truth to "I've also been told I have this circle of pain thing where I am unable to relax and let it heal possibly due to "over active nerves?""

But as you've alluded too, nobody's been able to tell you what to do about that.

For future reference, there's some good questions to ask your doctor about surgery: Quiz Your Doc

So....what have you been doing for post surgery self care?

Have you been Ice Dipping as described on the How To Reduce Inflammation page?

Are you doing anything about Magnesium For Tendonitis?


Did the doctors offer anything besides Anti-inflammatory drugs like Ibuprofen for those 'overactive nerves' of yours?
Jan 27, 2013
Rating
starstarstarstarstar 		DeQuervain's Sucks For This Dog Groomer
by: Winnipeg

Really happy that i have found this thread. I have this condition in both wrists, however the cortisone injection seems to have kept my left at bay for almost a year. I am a dog groomer, right hand dominant though and 7 months post op on the right wrist.

When my surgery was done i was told to start using my thumb the next day, just moving it around etc. I was in physio the following week where i was told i was too swollen and needed to stop using it so they gave me a splint. two weeks later my range of motion had not improved and then the therapists were yelling at me for not using it enough!

Long story short, I felt great when i returned to work a month post op (what the dr suggested due to the type of work i do) and I have had zero issues up until the holiday season which is incredibly busy. The pain right now is not keeping me from working as i have always been more comfortable when using the hand then at rest.

It is not anywhere near how bad it was but i am worried it will be back full force soon.

The idea of gluten sensitivity being at the heart of the problem is of great interest. About ten years ago my aunt and a few cousins were diagnosed with celiac and as a teenager i had always had stomach troubles so i got tested and came back "borderline".

I was sent for a scope and the specialist didn't find any internal damage so i was told i was fine. i am also testing anemic now and then and low vitamin D.

Might have to give the gluten free thing another go...I do not want to give up my career and i am not really crazy about going back under the knife either....

Thanks so much for the advise on here!


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Joshua Comments:

Hi Winnipeg.

Dog grooming certainly plays a role in thumb problems, as far as repetitive activity.

But if the body doesn't have the nutrition it needs, and if it's already in an inflammatory state, then it will have a harder time happily performing all the repetitive activity.

Gluten is an inflammatory agent. You don't have to be 'celiac' to suffer from gluten. It's like drinking gasoline. Yuu're not 'intolerant' to gasoline, gasoline is a poison.

Gluten is a poison. Some people can just deal with it a little better/a little worse than others.

And as it's generally in processed food form, there's not much nutrition in it. And you need nutrition.

There is no good reason to eat gluten, aside from being tasty in bread and cookie form.

So the whole thing you described with doctors....please delete that from your 'relevant' category. There's no such thing as 'borderline' celiac. It's all just a spectrum of gluten intolerance, from 'you don't feel it now but you will later when it's been slowly deteriorating your health for decades' to 'celiac'.


-CONTINUED IN NEXT SECTION-
Jan 28, 2013
Rating
starstarstarstarstar 		Joshua Replies to Winnipeg Dequervain's Dog Groomer
by: The Tendonitis Expert

-CONTINUED FROM LAST SECTION-

Also, ask your doctor why, if you tested low for Vitamin D, your doctor hasn't gotten your level up to normal/high normal levels yet? It should be considered malpractice to leave a person at low levels, but unfortunately it's not. Get your Vit D level up to between 60-80 ng/ml, this week.

What are you doing for the anemia?

You don't need to give up your career. You just need to outsmart your current state of health and get your body working healthy again.

I don't have my Dequervain's ebook finished yet, but you may want to get Reversing Wrist Tendonitis, do everything it says to do, and contact me and I'll fine tune it a bit for the thumb tendonitis and post surgery rehab.
Jan 29, 2013
Rating
starstarstarstarstar 		Fell On Ice, Dequervains surgery previously, what next?
by: Donna L

Fell on black ice 1/24/2012. Given brace, cortisone shots, meds. Had dequervains release 7/2012. Pt for about 6 weeks after surgery.

Still having tremendous pain in wrist and forearm. Can't tolerate cold at all, so ice dipping not ok. Not sure what to do next. Any ideas?...Ortho suggested rheumatoid arthritis dr (2 mRI shows no arthritis) possible neuro or pain management???


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Joshua Comments:

Hi Donna.

1. Did you fall on the hand/arm that had had the Dequervain's surgery? And do I correctly assume that the wrist and forearm you're having pain in is the side the surgery was on?

2. Doctors commonly send patients with wrist pain (and various other kinds of pain) to a rheumatoid arthritis doctor when they have no idea why you are hurting...even if it's something as simple as a tendonitis dynamic or as obvious as "I recently had dequervains surgery and then I fell on my arm and now it hurts."

If you don't have other rheumatoid arthritis symptoms, why would a doctor refer you to an RA specialist?

3. What self care were you prescribed post-surgery/

4. What self care did you do post surgery?


Let me know the answers to the above, and I can say more.
Jan 29, 2013
Rating
starstarstarstarstar 		Dequervains after a fall on ice
by: Anonymous

1. Yes, fall on the hand/arm that had had the Dequervain's surgery. Yes, the wrist and forearm I'm having pain in is the side the surgery was on.

I fell 1st and then had surgery.


2. I'm not sure why the doctor would refer me to an RA specialist.


3. 'What self care were you prescribed post-surgery?' Anti inflammatory, pain meds, brace, a few weeks of physical therpay and a few acupuncture treatments.

4. 'What self care did you do post surgery?' Heat, can't tolerate ice or cold.

Going to pain mgt dr tomorrow. Hope that is the right move.


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Joshua Comments:

Let me know what the pain management doctor says.
Dec 09, 2014
Rating
starstarstarstarstar 		Diagnosed de Quervains, suffering over 2 years!
by: In Canada II

I too am a sufferer. Its been over 2 years. I had a gradual onset with thumb pain and loss of use and was diagnosed 2012 with repetitive strain (years of keyboarding per the dr.). I started physio, had chiro, massage. Then in the middle of 2013 I developed shoulder impingement (frozen shoulder) and couldn't move my entire arm!

I was off work for over 2 months and continued with physio, chiro, which included trying all sorts of anti-inflammatory drugs and pain killers (none worked), and ultrasound, acupuncture, traction, exercise, etc. Mostly the manual manipulation physio worked on my shoulder (that was horribly painful).

I couldn't wash my hair, bathe properly, write, grab anything, cut my food, get dressed, clean my house, drive a car without fear of crashing, etc. It took over 2 months until I was able to move my arm but the thumb never got any better. I then ended up in the spring of 2014 with a bad flare up of the hand which now included the elbow.

My GP put me off work again. I was off for a month. I researched myself for other treatments. I found and tried shockwave theraphy. It was incredibly painful but I am willing to do anything to get past this disability. It helped the elbow but not the hand. My hand usually feels a bit better with constant treatment but does not get better.

Over the course of the 2 years I have gotten more and more depressed. I lost 15 lbs in 2 months without even trying! I had a mini nervous breakdown this Fall. My dr has booked me off work with severe anxiety and depression. I am taking medication for that now.

I've had several x-rays and ultrasounds over the course of 2 years. My neck, shoulders, right arm, elbow and hand are in constant pain. Like the other posters on here, anything I do I pay for it. I want relief. I want my life back. I am a 50 something woman. I can't vacuum my small house without having to rest my arm and hand for a few days following. I can't grab, lift or pour from a carton a glass of orange juice for pete's sake.

I can't work now due to the anxiety which I attribute to difficulties with my employer and wsib in regard to my condition!!

My dr doesn't recommend surgery. He feels it doesn't always work and can cause more problems. He has mentioned cortisone. I've not been a fan of putting that crap in my body and everything I've read says it could do more damage to the tendon sheath and in long term sufferers it is mostly only a band aid solution. It will come back.

I am seeing a osteopath now but that also doesn't seem to be doing anything. I'm so miserable but try to put on a brave face to friends and family. No one understands how debilitating this is.

I was thinking of telling my dr. I want to consider surgery but I'm afraid now after reading In Canada's experience.

I need help...is there a support group somewhere for this condition?


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Joshua Comments:

1. See: Quiz Your Doctor

What would they even do surgery on?

If you're talking about the Frozen Shoulder, then you should REALLY ask the questions from the Quiz Your Doctor page.

If you're talking about the DeQuervain's, then they'd cut the sheath around the tendon, but how does that affect the factors that caused the problem in the first place?

It doesn't.



2. Long story short, nutrition is probably your missing piece. Manual care can't work if the body doesn't have the nutritional building blocks to respond/adjust to it.

And depending on what you mean by 'frozen shoulder'...that can be a big deal if it's adhesive capsulitis you're talking about, as opposed to just really bad Shoulder Tendonitis.

3. Go to DeQuervain's Tendonitis, and read the links off there. Pain Causing Dynamic, Process of Inflammation, Shoulder Tendonitis (from the links on the left).

4. While DeQuervain's and shoulder tendonitis are different locations, that you have both going on tells us some things, i.e. your body isn't working optimally. Pain/problem starts in one area and due to how the body works, spreads. That's great the physio is/has helped the shoulder, but tendonitis is multifactored and if all you're doing is manual massage/stretching, chances are it will be back sooner or later.

5. As a general rule, it's all reversible, but one has to apply effective measures. And you've tried many measures that weren't, and one could say, aren't, effective.
Sep 15, 2016
Rating
starstarstarstarstar 		De Quervain Release and intersection syndrome complications post surgery
by: Wyomingite

I had surgery 6 months ago for the De Quervain Release and tenosynovitis or intersection release.

My hand was in a brace for 5 weeks and I was told not to take it out or use it to let the surgery heal. Sutures were not all removed until that time.

When the brace came off I could not bend my wrist - it was completely immobile.

The radial nerve was hypersensitive and nothing could touch my wrist it hurt so bad.

I started therapy and they have worked with heat, ultrasound, electrode stimulation, massage when they were able to finally touch my wrist and eventually manipulating and bending my wrist.

I have lots of exercises I do at home on a daily basis, multiple times a day with weights, squeezing my hand withe putty, etc. I also have a brace that you crank that bends the wrist and I wear it as frequently as I can.

I still have little downward movement and no side to side movement due to scar tissue. I no longer have pain and the De Quervain Release surgery definitely helped, but I now lack mobility.

My doctor wants to do more surgery to manipulate my wrist and possibly remove scar tissue. Is this my best option or can the scar tissue get better through continued massage and PT?

I'm worried I will have scar tissue build up again, because I am prone to it. I don't know if I can progress with my mobility without it cuz right now I'm not seeing it happening after 6 months post surgery.

Good news is I have full movement of my thumb pain free. I traded one thing for another I guess.

Thank you for any advice you can give me as my doctor wants to schedule this next surgery soon.



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Joshua Comments:

Hi Wyomingite.

1. Immobilization causes connective tissue to shrinkwrap. And muscles to get tight. And everything was already tight before surgery...now it's literally stuck tight tight.

2. So your lack of mobility is in large part due to that.

3. Plus nutritional insufficiency (which is part of why you were hurting in the first place).

4. What exactly would your doctor cut on to create more mobility?? That sounds like a bad idea, and I'd be asking a lot of questions about that.

See the Quiz Your Doctor link in this thread.
Oct 18, 2016
Rating
starstarstarstarstar 		and so it goes.......
by: Canada TWO

Over five years since diagnosis and treatment, over four years since surgery......
I still have problems and pain with my wrist. :(


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Joshua Comments:

:(

What treatments did you try?
Oct 18, 2016
Rating
starstarstarstarstar 		Agree with Canada Two
by: Anonymous

I had my surgery in January of 2010 and I also still have pain and a reduced range of motion.

On the bright side, whatever was going on in my shoulder has finally settled after 4 years (but with the onset of winter I'm not convinced it will stay settled) so maybe this means the pain in my wrist will start to go away and the function of my hand will return.

Here's hoping!
May 07, 2017
Rating
starstarstarstarstar 		Same problem, 3 surgeries in and not healed
by: Felicia

Hello!

I'm sorry you are going through this! but I am glad I stumbled across this for I am going through the same thing! and am very frustrated at the outcome from surgery.

I was injured in 2013 at work; I am a CNA and work with elderly patients. I was diagnosed with De Quervain Tenosynovitis.

I've tried everything from multiple injections to physical therapy and occupational therapy, Pain management, 3 surgeries, seeing almost all the specialists in my area. I am still not healed and have been out of work since my last surgery in June of 2016.

The first surgery was unsuccessful in that the surgeon didn't do the procedure right, he didn't wrap the tendons right and ended up wrapping a nerve into the tendons, which injured the nerve, a little over a year later after doing physical therapy for forever and still not making progress.

I had a second surgery in Oct of 2015 to repair and fix what the doc had later found out what had happened. After that second surgery I still wasn't having any relief and in physical therapy, I would get to a certain point only excelling a couple points in all areas my therapists would test, we tried a few injections to see if they would work after the second surgery and found out that my body doesn't like cortisone and I had an adverse reaction to it.

which lead us to pain management where I was put on Lyrica, Cymbalta, and zipsor. these did make the pain, for the most part, go away, but only enough so that I could function a little better than I had been. I was able to return to doing crocheting and was able to start driving my car without a brace and was starting to be able to do the dishes in a timely manner again instead of it taking 2 hrs due to the pain.

So after trying various drugs and seeing several other physicians, surgeons and plastic surgeons I found a surgeon who thought I had a neuroma and talked to me about doing a third surgery to remove it since it wasn't dissolving on its own.


Talking about a third surgery was scary and it took me almost a month and a half of asking questions and really praying about it to know if it was the right thing to do or not. Finally, I agreed, in the thought process of well " I'd never know if this would help if I don't give it a shot." I agreed to a third surgery in June of 2016.

Since last June I've struggled with doing a lot more than I have had to since the second surgery.

The pain has been different more sore and numb and more like nerve pain. I've had to increase my dose in my Lyrica to help with the pain and am now seeing the final and last doctor in Idaho that I can see before I have to seek treatment elsewhere, such as university of Utah hospital.

I am back in physical therapy to help with AROM and Pain. I'm currently wearing pain patches 12 hrs a day over my incision site to try and help with pain.

I'm so very frustrated. My new doctor thinks that another nerve is involved in the injury since the last surgery. And i am really not wanting a 4th surgery to "see if it will make it better" or at least tolerante so i can continue with my life. August will be 4 years since my injury, i'm really ready for this to be better!

Sorry for the long post and back story, my question for you is if you have found something that has helped? Where are you in the treatment phase? did it ever finally heal?

Thanks!


Dec 28, 2017
Rating
starstarstarstarstar 		Regret my surgery
by: Karen

I am 4 months post surgery for carpool tunnel and De quervains surgery.

My carpool tunnel has healed fine but my de quervains is I would say much worse. My thumb is quite floppy and I can't seem to control it and the pain is at the base of the thumb. My wrist is swollen and numb and sore. I've been back to see my surgeon who basically told me I am very anxious and not letting myself heal.

He also said usually people are 100% better after 3 months and that I am going to be the small % that take a lot longer.

That was a month ago and I am waiting for an appointment to have an ultrasound. I feel terrible it has made me really depressed. I have just gone through Christmas trying to be happy for my family.

I can't brush my hair with my right hand can't brush my teeth use a tin opener. Twist a jar open pour milk out of carton lift anything heavier than a cup. I also work in a school with children and can't do any activities which involves using my hands.

So I wish I had a time machine and I would never have had the surgery.


Kind Regards. Karen from Suffolk uk


Jan 04, 2018
Rating
starstarstarstarstar 		Pins and needles on right hand fingers and pain radiating to forearm after de quarvains release surgery
by: Anonymous

Hi,

A week after my surgery for De quarvains ( right thumb and wrist), I have pins and needles on my fingers especially the 3 middle fingers and pain radiating to my forearm and shoulder.

Had ultrasound done and it only showed little thinckening of PIN. Had MRI done but all looks normal apart from my ulnar nerve in cubital tunnel demonstrates instrasubstance hyperintense cystic lesion of 4mm x 5mm, which can be an intraneural ganglion or cysts.

I have been on physiotherapy for almost 4 months and it doesn’t get rid of pins and needles and pain.

I dont know what to do and dont want them to think that I am faking my pain. What shall I do? Any suggestions of other tests that needs to be done?

Physiotherapist thinks pain comes from my neck and shoulder that causes the pins and needles and pain on forearm. Need your help. Thanks.


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Joshua Comments:

Hi Anonymous.

1. Then your physio should do the work on the neck and shoulder to fix that/stop that pins and needles thing.

2. It could easily be from post-surgery swelling and tightness (and inflammation process)...plus as surgery ignores all the causes of dequervain's...all the factors that caused the dequervain's in the first place that are A. still in place and B. worse/aggravated by the surgery.
Jul 15, 2018
Rating
starstarstarstarstar 		Similar issue
by: Joy

The middle finger on my eright hand appears to have become a trigger finger; but my dr pressed below that finger, I think he was expecting it to "trigger". It did nothing. He gave me a cortisone shot 7 days ago but my finger locked-up again this morning followed by repeated less severe pain.

Is there a condition that mimics trigger finger?


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Joshua Comments:

There kind of are, but it's more likely you're just looking at a flavor of trigger finger dynamic.

Just because it didn't pop like the doctor thought it should doesn't mean it's magically not a trigger finger dynamic.

Either there's a 'trigger' behavior, or there's a locking and pain behavior....both from teh same dynamic...just behaving a little differently.


I guess you could have single joint rheumatoid arthritis or something where the joint is inflamed and deforming....do you have rheumatoid arthritis?
Sep 11, 2018
Rating
starstarstarstarstar 		Radiating pain after dequervain's surgery
by: Cara N

I had DeQuervain surgery in August of 2015...after that it took months to recover and my doctor gave me a cortisone shot and gave me a splint to wear...After about 9 months it was good...now it's back...the pain is in the same spot and the pain that shoots up my wrist into my elbow is beginning to get to me bad...

After the surgery they told me that I really needed it because it was so tight in there they were surprised I could even use the thumb...I have RA (rheumatoid arthritis) as well but no other joints hurt and it truly is the same pain as before - only worse...I've tried icing it nightly - resting it when I can and I wrap a bandage around it to brace it more than anything...I don't really want to go back in cause I'm afraid it will be another surgery and it obviously didn't help...can it come back in the same spot?

I had a desk job for 33 years and then retired...I'm 51...I tried 6 months of doing nothing and I went back to work just to have something to do...my job now involves a lot of heavy lifting and I've been at it since November...the past month - the pain has come back in droves...there have also been a couple of episodes where my pointer finger will cramp and freeze into position...no hot spots when pushing and no visible swelling on the outside...

Can you please advise on things I can try...medication doesn't help and resting doesn't help...please - any suggestions would be much appreciated...

Have a great evening!


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Joshua Comments:

Hi Cara.

Unfortunately you didn't leave your email address nor check the notifications box, so it's unlikely that you're going to see this response.

So I'll drop this info in that would be relevant to you.

1. Read this entire thread and follow the links and read those pages. THat will get you up to speed on the tendonitis dynamic and how/why you are hurting.

2. THese are very relevant for the RA.

See: What Is Arthritis?

See: What Is Osteoarthritis?

See: Rheumatoid Arthritis Symptoms
Mar 01, 2019
Rating
starstarstarstarstar 		2 x surgery no avail
by: Aus

I stumbled upon this thread several years ago after my first surgery which failed completely, the surgeon carried out a second release in which he stated the sheath had grown back?

Multiple cortisol injections worked particularly the first one, not a solution long term though as the effect simply fades. The inflammation in the tendon was very visible under ultrasound.

After the second release where the surgeon actually removed sections of the sheath the pain and discomfort simply came back to a mild level, as using my effected arm with any sort of twisting motion or heavy load on the wrist results in now visible swelling in the thumb/wrist area. overall worse.

The thing with this injury I have always stated to the specialists, either physio, surgeons, occupational therapists and so forth that the issue is extending through the forearm into the wrist.

I have been tested for arthritis, rheumatoid arthritis etc. Since the original surgery I have changed my diet and lifestyle completely with absolutely to positive improvement in my wrist.

pain killers, anti inflammatory drugs have no real positive effect, an ice pack or cold spray instantly dulls the ache and improves movement.

The most significant issue it causes is that it wakes you from your sleep with a dull ache, this gets very tiresome very quickly.

I am now self employed and just have to live with it, if it flares up I have to back off using it or it only gets worse.



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Joshua Comments:

Hi Aus.

The reason surgery didn't fix anything is because the sheah isn't and wasn't the problem.

This is a simple truth that the doctors etc should know, but for some mind boggling reason, don't. Or don't care to know, being surgeons whose bread and butter is blaming the tendon/tendon sheath and cutting on it.

The probme is the tendonitis dynamic: too tight muscle and connective tissue, inflammation process, and lack of nutrition.

Diet may help but once you're in a nutritional hole, diet is unlikely to fill that hole.

How are things feeling now, it's been a while since you wrote this.

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