Date of Award

2013

Document Status

Open Access

Degree Type

Project

Degree Name

Occupational Therapy (M.S.)

Department

Occupational Therapy

Abstract

Introduction: De Quervain’s tenosynovitis is a repetitive stress disorder occurring at the first dorsal compartment of the wrist at the radial styloid and is commonly treated by hand therapists.1-3 Conservative treatments include activity modification, modalities, orthotics, and manual therapy.4-7The literature is unclear regarding best practice for treating de Quervain’s tenosynovitis with conservative methods.5,8,9

Purpose of the study: The purpose of this study was to identify which treatment or treatment combinations was most effective to reduce pain and improve functional outcomes for patients with de Quervain’s tenosynovitis.

Methods: A retrospective chart review was conducted with 42 patients seen in outpatient therapy. Patient pain was measured using the Numeric Pain Rating Scale (NPRS) and the QuickDASH was utilized to assess functional outcomes.10,11

Results: Both iontophoresis with dexamethasone and therapeutic pulsed (20% or 50%) ultrasound (1.0-1.5 w/cm2) were found to have clinical significance as well as statistical significance on the QuickDASH (p= 0.028) and NPRS (p= 0.046) respectively. Other treatment methods were found to be clinically significant but not statistically significant. Demographics of this sample were reflective of the literature as there were 32 women and 10 men.6 The mean age of the sample was 39.13 years (range 19-63 years).

Conclusion: This study demonstrated that iontophoresis with dexamethasone may improve functional outcomes while therapeutic pulsed (20% or 50%) ultrasound (1.0-1.5 w/cm 2 ) may be effective in decreasing pain in patients with de Quervain’s tenosynovitis.

Level of Evidence: 4.12

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