Physical Medicine and Rehabilitation for De Quervain Tenosynovitis Follow-up
- Author: Patrick M Foye, MD; Chief Editor: Stephen Kishner, MD, MHA more...
Further Outpatient Care
Have the patient return for reevaluation approximately 2-4 weeks after corticosteroid injection.
At the time of the follow-up visit, assess for therapeutic response to the injection and evaluate for any complication or further treatment needs.
Instruct the patient to contact his/her physician sooner if a significant progression of symptoms is noted or if local signs of infection are present at the injection site.
Inpatient & Outpatient Medications
Please see Medication.
A patient with de Quervain tenosynovitis may need to avoid certain repetitive activities of the wrist or thumb until adequate rehabilitation has been achieved.
Please see Other Treatment, which includes a discussion of potential complications of corticosteroid injections.
Most patients with de Quervain tenosynovitis respond very well to nonsurgical treatment (eg, corticosteroid injection, splinting, physical therapy, occupational therapy).
For severe cases that are unresponsive to injections, refer the patient for surgical treatment to decompress the first dorsal compartment.
A literature review by Cavaleri et al indicated that the combined use of orthoses and corticosteroid injections for de Quervain tenosynovitis is more effective at improving pain and function than the use of either treatment by itself.
As with any injection, educate the patient to watch for signs or symptoms of local infection at the injection site.
Instruct diabetic patients that they may experience a transient increase in blood glucose levels with corticosteroid injection.
Educate patients that symptomatic improvement from corticosteroid injection usually is observed a few days after injection. Patients should understand that they may experience a mild, transient increase in symptoms during the period in which the local anesthetic has worn off but the steroids have not yet begun to demonstrate a noticeable therapeutic effect.
For patient education resources, see the Hand, Wrist, Elbow, and Shoulder Center and Sprains and Strains - First Aid and Emergency Center, as well as Repetitive Motion Injuries and Sprains and Strains.
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