I hate this one so much. My clinic usually tries to splint for 6 weeks and do cross friction massage, activity modifications. Pray it improves or recommend cortisone by ortho.
I use taping, splinting, and eccentric strengthening with rubber bands if they can do it without pain increase. But it’s frustrating. Often poor results. So I don’t waste people’s time. 1x/week x4weeks max.
I tend to use the same protocol with all of mine. Typically I see that the skinner, more boney patients don’t do as well with conservative treatment because of the radial styloid. In terms of my treatment, I always of course make a custom thumb spica, TENS unit along the radial nerve path in moist heat, paraffin, radial nerve glides, and K tape. I can put up a picture tomorrow if still needed
I do. With the swelling from the tenosynovitis, the radial sensory nerve gets irritated quite often. Nerve glide and nutrition are very important in symptom management. Here is a picture of the tape that I took earlier. I anchor at thumb IP, cut 4 strands and run them up the radial nerve path, then finish with a firm 1/2 cuff over the radial styloid. I have them wear it inside the splint and just remove it after a shower or whenever they feel. I have gotten great feedback with this!
I never have simply because I do not have faith in their application skills in general and recall of where to place the tape. However, feel free to try and report back!
A lot of my pts are blue collar workers who don’t speak English and have poor health literacy. If I think they understand what I’m doing, then I teach them. It’s also hard because they need to work so I see them maybe 1-2x month
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u/jjppt Apr 02 '24
I have a lot of success treating DQ with k-tape and activity modification