DeQuervain’s Tenosynovitis treatment with PRP is gaining recognition as a promising regenerative therapy. First described by Swiss surgeon Fritz de Quervain in 1895, this condition involves swelling or stenosis of the tendon sheath surrounding the abductor pollicis longus and extensor pollicis brevis. This inflammation thickens the sheath, leading to severe pain, swelling, and restricted thumb movement.
Causes and Risk Factors
This disorder commonly affects middle-aged women and individuals engaging in repetitive thumb and wrist movements. Contributing factors include:
- Repetitive Motion – Activities like sports, gardening, and knitting can cause excessive thumb abduction and wrist ulnar deviation, leading to inflammation.
- Trauma – Injuries to the radial or thumb area often trigger swelling of the tendon sheath, particularly in individuals in their 50s and 60s.
- Hormonal Influence – Pregnancy-related fluid retention increases susceptibility, suggesting a hormonal component.
- Anatomical Variations – Some individuals have a septum within the first dorsal compartment, predisposing them to this condition.
Symptoms and Clinical Presentation
Patients typically experience localized pain near the radial styloid of the wrist, often extending into the thumb. Other symptoms include:
- Swelling and tenderness in the affected area
- Warmth around the radial styloid
- Pain elicited by the Finkelstein test, where the thumb is placed in the palm, and the wrist is deviated toward the ulnar side.
- Decreased grip strength and difficulty grasping objects
- Clicking or snapping sensations when moving the thumb
Pathogenesis
DeQuervain’s Tenosynovitis results from repetitive microtrauma to the tendons in the first extensor compartment. Continuous friction over the radial styloid thickens the tendon sheath, leading to chronic inflammation, tendon fibril degeneration, and tendinopathy. This progressive deterioration can result in worsening symptoms and long-term dysfunction if left untreated.
Diagnosis
A thorough history and physical exam are essential for diagnosis. Key diagnostic indicators include:
- A recent change in wrist-intensive activities
- Positive Finkelstein test
- Swelling and tenderness at the radial styloid
Imaging may be necessary in some cases:
- Ultrasound – Used to rule out ganglion cysts and confirm tendon thickening.
- X-rays/MRI – Recommended if trauma is suspected to assess fractures or arthritis.
If left untreated, this condition can result in chronic pain, reduced grip strength, and, in rare cases, tendon rupture.
Treatment Options
DeQuervain’s Tenosynovitis Treatment has been widely studied as a regenerative approach, offering a long-term solution for pain relief and tissue healing.
Conservative Treatment
- Rest and Activity Modification – Avoid repetitive wrist motions.
- Thumb Spica Splint – Immobilizes the wrist for recovery.
- NSAIDs – Reduce inflammation but pose risks like gastric, renal, or hepatic complications.
- Physical Therapy – Strengthens the wrist and restores pain-free motion.
- Shockwave Therapy – Used to alleviate pain and stimulate tissue repair.
- Ultrasound-Guided Therapy – Helps target treatment directly at the affected tendon sheath.
Injectable Treatments
- Corticosteroid Injections – Reduce inflammation but pose risks such as tendon rupture, muscle atrophy, and pigmentation changes.
- Platelet-Rich Plasma (PRP) Therapy – A regenerative alternative that enhances healing by delivering growth factors and bioactive proteins to the damaged tendons. PRP has shown promising results in long-term pain relief and functional recovery compared to corticosteroid injections.
Surgery
Surgical intervention is rarely required unless an anatomical variant or traumatic damage leads to irreversible stenosis of the tendon sheath. However, surgical complications can include incomplete release, nerve injury, neuroma formation, hypertrophic scarring, and tendon subluxation.
Scientific Evidence Supporting PRP for DeQuervain’s Tenosynovitis
The Use of Platelet Rich Plasma in DeQuervain’s Tenosynovitis: A Systematic Review (Cureus, 2024)
A systematic review analyzed eight studies, including randomized controlled trials and experimental studies between 2017 and 2023. Findings showed PRP was superior to corticosteroids, offering longer-lasting pain relief with minimal side effects. PRP also demonstrated:
- Reduced tendon and sheath thickness
- Decreased extensor retinaculum thickness
- Significant reduction in tendon sheath effusion and peritendinous hyperemia
Current Status and Advancements in PRP Therapy (Cureus, 2023)
This exhaustive review highlighted Level 1 evidence supporting PRP for hand pathologies. A study comparing PRP and corticosteroids in 40 patients found PRP to be superior in midterm follow-ups due to its regenerative properties.
The Role of PRP vs. Corticosteroids in DeQuervain’s Tenosynovitis (Med J Cairo Univ, 2020)
A cohort study demonstrated that PRP significantly improved pain intensity, disability, and ultrasound findings. Unlike corticosteroids, PRP promotes self-healing without adverse effects.
Why Choose Juventix Regenerative Medical for PRP Therapy?
Juventix Regenerative Medical leads the industry in safe and effective PRP solutions. Our FDA-cleared PRP kits ensure sterility and optimal platelet concentration, free from excessive red blood cells and leukocytes.
Key Benefits of Juventix PRP:
- LED Activation Technology – Enhances growth factor release without chemical additives like Calcium Chloride, Thrombin, or Collagen.
- Patented Bio-Incubator – Converts PRP into Injectable Platelet-Rich Fibrin (PRF) for superior anti-inflammatory effects.
- Comprehensive Regenerative Solutions – We provide cutting-edge products and expert support to enhance patient outcomes and satisfaction.
- Minimal Manipulation Standards – Juventix PRP solutions comply with FDA regulations to ensure safe and effective regenerative therapy.
Conclusion
DeQuervain’s Tenosynovitis treatment with PRP is a revolutionary approach that not only reduces pain but also regenerates damaged tendons. PRP outperforms corticosteroids in long-term relief and healing. Considering the growing body of evidence, PRP should be a frontline treatment for this condition.
RESTORE, REVIVE, REGENERATE – JUVENTIX REGENERATIVE MEDICAL
Regenerative Regards,
Dr. Robert McGrath
