Rose is a 30 years old.  She is a keen tennis player and works in an administrative role in a busy office.  She recently helped her parents to move house.  Following a week of packing, unpacking, manoeuvring furniture and some decorating, Rose was aware of a tenderness and swelling in a specific area of her right wrist, at the base of her thumb.  She assumed this was just a sprain and would settle, but the symptoms became worse.  Rose experienced pain when using her right thumb and wrist.  This affected many aspects of her life, such as applying makeup, washing and drying her hair, playing tennis and many work related tasks.

Rose self-referred for hand therapy.  Following assessment, Rose was told that she had symptoms of tendinitis, known as DeQuervains.  This was affecting specific thumb and wrist movements.  Two tendons responsible for opening the thumb had become inflamed and swollen in a specific area, which was very tender to the touch.  Rose was advised on the use of anti-inflammatories and icing the tender area.  A customised thermoplastic splint was moulded to Rose’s thumb and wrist.  This allowed use of the tip of the thumb, but restricted use of the thumb movements which were aggravating Rose’s condition.  Rose was advised to wear the splint as much as possible, ideally full time, removing only for bathing. She could not play tennis during this phase and was placed on light duties at work.

Rose was reviewed 4 weeks later.  The pain had almost settled.  The thumb was stiff upon opening and stretching.  Some pain remained on sideways movements of the wrist.  Rose was taken out of her plastic splint and advised to wear this only for heavier tasks which she felt aggravated her thumb.  Kinesiology tape was applied to the thumb, along the length of the affected tendons, thus taking some strain off these tendons.  Rose was taught to reapply this herself as needed.  A soft neoprene splint was applied.  This offered some support to the thumb and affected area of the wrist and was to be used largely at work.  Thumb and wrist exercises were taught to regain full movement.

Rose was seen a week later.  She was back on full duties at work and managing in her soft splint and kinesiology tape, reverting back to her plastic splint towards the end of the day as her hand tired.  Thumb and wrist strengthening exercises commenced.  A graded programme was prescribed giving Rose the ability to progress the exercises as her thumb became stronger.

Rose was seen a week later.  She was then free of pain and had a full range of movement.  Rose was advised on continued strengthening and advised to return to tennis with the support of her kinesiology tape initially.  Rose was discharged at this point.