De Quervain Disease

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It is due to inflammation and swelling of the thumb tendons. That is why there will be pain that makes thumb and wrist movements difficult. The pain may also radiate into the forearm.

The causes or the risk factors of De Quervain disease are:

• Chronic overuse of the thumb
• Blunt injury of the thumb
• Occupations or hobbies involving repetitive thumb motion such as carpenter, gardening, gaming, or typing
• Disease conditions like rheumatoid arthritis
• Pregnancy

If you have De Quervain disease, you may experience the following symptoms:

• Pain when moving the thumb to make a fist or for other activity
• Tenderness and swelling at the base of the thumb
• Pain, swelling, and tenderness on the thumb side of the wrist
• A sticking, catching or snapping sensation during thumb motion
• Difficulty moving the thumb and wrist
• Reduced grip or pinch strength

The pain may radiate into the forearm if it goes unchecked.

Diagnosis of De Quervain Disease?

Diagnosis is based on the physical examination of your thumb. We will look for swelling and tenderness.

Next, we will ask you to perform the Finkelstein test. In this test, you will bend your thumb across your palm and place your fingers over your thumb to make a fist. Then, you will move your wrist towards your little finger. If you feel pain performing this test, you have De Quervain disease.

What are interventional Pain Management options?

• There is inflammation around the tendon. That is why steroid injection helps to reduce inflammation and pain.
• Sometimes there is degenerative tendinopathy. That is why injection of platelet-rich plasma with or without hyaluronic acid at the site of pain may be useful

PRP THERAPY

Platelet-rich plasma is a form of regenerative medicine. It uses injections of your own blood platelets to help with healing.

What Is Platelet-Rich Plasma?

Platelets, or thrombocytes, are a type of blood cell. Their main function is clotting blood. They’re produced in your bone marrow. Platelets contain growth factors. These are proteins that may be helpful in healing injuries.

How Does Platelet-Rich Plasma Work?

A healthcare professional will collect a small amount of your blood (approx. 15-20 ml only). They will place your blood into a centrifuge. This spins your blood at different speeds until it separates into different layers. One layer is the platelet-rich plasma. This layer of plasma may have as much as three-four times more platelets than regular blood.‌

The platelet-rich plasma will then be injected into your affected area. We will first numb the area with a local anesthetic. The pain at the site may increase for the first 1-2 days. It could take 1 week before you feel any improvement.‌

After your treatment, we will recommend you to:

• Avoid taking non-steroidal anti-inflammatory medications ( NSAIDs) after your treatment as this may block the effect
• Avoid activities that put stress on the area of treatment for a few days

Is Platelet-Rich Plasma Treatment Effective?

The effectiveness of platelet-rich plasma treatment depends on several factors, including:

• Your overall health
• Whether your injury is chronic (it developed over time) or acute (sudden and serious)
• Which part of your body needs treatment
• The preparation of the platelet-rich plasma treatment

Many clinical trials have supported its use.

Some studies have found that platelet-rich plasma injections significantly reduced pain compared to placebos. People’s physical function also improved significantly. These benefits continued at 3, 6, and 12-month follow-ups.

There’s no chance of an allergy or immune reaction to platelet-rich plasma treatment because the plasma is taken from your own blood. Side effects and complications are rare

What does the procedure involve?

The doctor will clean the area over the joint and insert a small needle into the fluid-filled area around the joint bones under imaging guidance. When it is in the correct position, they will inject the PRP into the joint. They will remove the needle and cover the injection site with a small dressing.

Why Not (Contraindication)?

Occasionally it is difficult to inject much medicine into the joint space, especially if the joint is extremely swollen. If this is the case, other medicines may be prescribed to reduce the swelling before the injections are tried again.

What you are to do before the procedure (Preparation)?

1. Book a prior appointment if elective or get admission in causality if an emergency
2. Lab investigation (*PT/INR, CBC), XRAY, CT/MRI scan, and previous records.
3. 2-3 Hours fasting.
4. If you are on a blood thinner like Aspirin, inform us during the appointment.
5. One accompanying person
6. Need to sign a consent form for the procedure

Approx. Stay in the hospital?

We have a very fast and competent working team (Consultant, fellow, clinical assistant, technician, and ward assistant) which provides you with a comfortable atmosphere and eases your nerves. The usual time of stay is around a few hours.

Complications

Every procedure carries a risk, although this is extremely small. The risk of infection with this procedure is extremely small as no incisions are made in the skin.

Resume working?

You can resume your work after 1 day if the existing disease allows.