De Quervain’s Tenosynovitis- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Introduction

De Quervain’s tenosynovitis is a very painful condition that affects mostly ladies of the age 30 to 50. This causes debility of the hands mostly thumps that restricts the movements of them. It is more evident in people who works the most time in their computer. Movements that needs the movement of wrists like doing dishes, writing, drying of clothes etc are also tend to be affected due to this disease.

Signs and symptoms of De Quervain’s tenosynovitis

Pain in the wrist and the area near the base of the thump

Difficult movements or restricted movements of the wrist and fingers, especially thump

S feeling of stick inside in the thump or pain on and off in the area

Oedema of the hand, more in the wrist area

Causes of De Quervain’s tenosynovitis

Exact cause is still not clear. Butr many risk factors are identified, like lifting weight with bare hands, repetitive movements or actions that include wrist and thump, chronic diseases like diabetes or rheumatoid arthritis etc. Pregnancy can also be seen as a triggering factor in some cases.

Pathophysiology of De Quervain’s tenosynovitis

Tendons of abductor pollicis longus and extensor pollicis brevis develops in De Quervain’s tenosynovitis at the level of the radial styloid process.

Diagnosis of De Quervain’s tenosynovitis

Physical examination including Finkelstein test, in which thumb is bent across the palm followed by bending of other fingers over the thumb. After that, the wrist is bent towards the little finger and if this causes pain in the wrist near the thumb, then this test is considered positive and the diagnosis is taken as De Quervain’s tenosynovitis

Usually, imaging tests like X rays are not used to diagnose this condition

Treatments for De Quervain’s tenosynovitis

  • First and foremost, the method is to immobilise the area. It is important to keep the thumb and wrist straight with a splint or a brace to give rest to the ligaments and tendons.
  • Avoid movements of the area as effectively as possible.
  • Moving of the thumb and wrist should be avoided especially sideways.
  • In more serious cases, surgery is needed to release the pressure and remove inflammatory residue.

Prognosis of De Quervain’s tenosynovitis

Most cases of De Quervain’s tenosynovitis show good results when immobilised properly. It is always good to start the treatment early to get better results. Surgery may not be needed if immobilised in the early stages, but even cases after surgery show high success rates.

Complications of De Quervain’s tenosynovitis

Though the condition seems not much serious, untreated cases of De Quervain’s tenosynovitis may lead to serious complications like oedema, bruises, excessive bleeding and collection of blood under the skin or any wound(haematoma). Such conditions may cause serious infection or dehiscence of the wound (cutting open the wound edges due to defective healing).

De Quervain’s tenosynovitis and Ayurveda

Sandhigatavaata

Nidana-Ayurvedic causes

Dhaatukshaya(degeneration)

Aavarana(obstruction to channels in the body)

Poorvarupa- Ayurvedic premonitory signs and symptoms

Not mentioned

Samprapti-Ayurvedic pathogenesis

Due to the causative factors Vaata gets vitiated and gets lodged in the joints causing pain and swelling.

Lakshana – Ayurvedic signs and symptoms

Vaatapoornadrutisparsam          – Feel of an air-filled bag on touch

Sopham                                           – Swelling

Prasaaranaakunchanayo: savedanaam pravrthim- Painful movements of joints like flexion and extension

Sadhyasadhyata-Ayurvedic prognosis

Yaapya (manageable with medicines, therapies and Pathya)

It is saadhya/krichrasadhya if it is new and involves only singe joint.

Chikitsa-Ayurvedic treatment

Samana

Lepana with soolaharadravyas

Parisheka with soolaha-sothahara dravyas

Upanaha with Vaataharadravyas

Sodhana

Sneha (Abhyanga)

Sweda (Potalisweda)

Vasti

Virechana

Raktamokshana

Commonly used Ayurvedic medicines for

Maharasnadi kashayam

Pachanamrutham Kashayam

Sahacharadi Kashayam

Rasnasunthyadi kashayam

Amruthotharam kashayam

Rasnerandadi kashayam

Amruthaguggulu

Kaisoraguggulu

Guggulutiktaka ghritham

Vatagajankusha Ras

Shadpala Ghritham

Home remedies for De Quervain’s tenosynovitis

Pain medications to manage the pain.

The RICE mnemonic is helpful, especially when the pain if injury happens:

Rest: Rest the joint, take a break from activities involving the affected joint.

Ice: Applying ice pack locally

Compress: A compression bandage can help prevent swelling and help alignment. It should not be too tight and should be removed at night.

Diet and behaviour

  • To be avoided

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Green gram, soups, sesame oil.

Ragi products

If having good digestive power, have milk and milk products except curd

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Behaviour:

Protect yourself from very hot & cold climates.

Better to avoid exposure to excessive sunlight wind rain or dust.

Avoid lifting heavy weights and other vigorous physical activities.

Avoid excess physical exercise, continued sitting and a sedentary lifestyle

Maintain a regular food and sleep schedule.

Practise frequent movements of fingers while working

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Yoga and Pranayama

Vigorous exercises are not allowed in very painful conditions.

Only stretching, moderate walking, and mild cardio exercises are advised

Sookshmavyayama of Sandhi’s

Gomukhasana

Research papers

https://www.jaims.in/jaims/article/view/1996

The Food and Drug Administration, United States has not evaluated these statements. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

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Writer:

Herbal-Doctor-Vaidya
Dr. Rajesh Nair Consultant, Ayurveda Medicine, India

Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

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