"Working Hands" - Tenosynovitis Rehabilitation Treatment
01 Main performance
1. Pain. Most of them can't clearly point out the painful part, but only complain that the joints are "awkward".
2. Local swelling. The affected tendon will have a cord-like bulge, with varying degrees.
3. Infection. The infection spreads to the subcutaneous tissue and is accompanied by redness and swelling. The infection can spread to the muscle belly along the tendon sheath, and sometimes there is pus in local puncture.
4. Dysfunction. Tenosynovitis that occurs in the wrists of the upper extremities often affects the force, and the patients have difficulty flexing their fingers. In the morning, the affected fingers feel stiff and painful.
02 Confirmatory examination
1. Local tenderness: obvious tenderness in the injured tendon sheath and its surroundings.
2. Positive resistance test: put the thumb in the palm, then make a fist, and when the wrist joint is bent toward the little finger, there will be severe pain in the wrist joint on the side of the thumb, suggesting that there may be symptoms of tenosynovitis, and it is recommended to seek medical treatment in time. Normal people will also have mild discomfort, but no pain.
03 Clinical treatment
1. Local immobilization therapy: In the acute attack stage of tenosynovitis, external fixation can be used to immobilize the patient to reduce local activities, reduce further strain and friction, and help reduce local traumatic inflammation. Take a full rest for about 3 weeks, and pay special attention to reducing manual labor that causes illness.
2. Blocking treatment: As the first choice of conservative therapy for clinical treatment, local sealing with hydrocortisone acetate, triamcinolone acetonide acetate or prednisolone acetate injected into the tendon sheath is very effective for early tenosynovitis. Once a week, usually 4-6 injections can heal.
3. Physical therapy: Shock wave therapy is a common physical treatment method for tenosynovitis. The positioning is based on the anatomical landmarks on the body surface, and the touch point is the impact point, avoiding important blood vessels and nerves. It can be felt by the patient, fine-tuned according to the shock wave energy from low to high, depending on the tolerance of the patient, and each shock is 2000-3000 times. Other physical treatments include: laser, wax therapy, magnetic therapy, ultrashort wave, ultrasound, and intermediate frequency electric therapy, all of which have different curative effects.
4. Surgical treatment: strip or remove the narrow tendon sheath, so that the tendon sheath no longer squeezes the tendon, and can achieve the purpose of radical treatment. Surgical treatment is only considered for patients with a long course of disease, recurrent attacks, and non-surgical treatment ineffective.
04 Self-exercise
1. Joint range of motion exercises
(1) Actively flex your fingers and wrists to the maximum extent.
(2) Actively straighten the fingers and perform the movement of raising the wrist.
(3) The wrist joint deviates to the little finger side.
(4) The wrist joint deviates toward the thumb.
(5) Bend the elbows at 90 degrees, with the palms facing up, so that the forearms rotate toward the center of the body, and then rotate outwards.
The above actions are maintained for 5-10 seconds each time, and then relax, 3-5 groups per day, 8-10 times per group.
2. Passive wrist stretch
When performing passive stretching of the wrist joint, it is necessary to use the uninjured hand to assist, that is, use the unaffected hand to press the back of the affected hand to bend the wrist joint as much as possible to the palm of the hand and keep it still. Keep the palm or fingers on the affected side to extend the wrist joint to the back of the hand as much as possible and keep it still. The above actions are performed in 3-5 groups per day, 3-5 times in each group, and each action is maintained for 15-30 seconds. When completing this action, you can also use a wall or a table to assist. as the picture shows:
3. Strength exercises
(1) Hold a dumbbell in your hand and bend your wrist to practice.
(2) Hold a dumbbell in your hand and raise your wrist to practice.
(3) Hold the ball in your hand and do strength exercises.
(4) Finger tension exercises.
Do 3-5 groups of the above actions every day, 10-15 times per group.
