Therapy

The therapy of a tendon inflammation of the thumb is almost always performed conservatively, i.e. not surgically. If the diagnosis of an inflammation of the tendon of the thumb has been made, the thumb should first be treated consistently. This can be guaranteed by a bandage.

Regular cooling also leads to a rapid improvement of the symptoms. The protection and cooling should be carried out for a few days. Under certain circumstances, taking an anti-inflammatory drug can also lead to a faster healing of the inflammation.

Pain gels such as Voltaren, which are applied to the thumb joint, would be suitable here or, if the tendon inflammation is severe, anti-inflammatory tablets such as Ibuprofen or Diclofenac can also be used. The drug treatment should not initially exceed one week and if there is no improvement in the symptoms, a new diagnosis should be made to show whether the pain is perhaps caused by a cause other than tendonitis. There are some cases where an inflammation of the tendon of the thumb is so severe and spreads throughout the entire wrist that surgical repair is necessary.

An operation is always performed when the inflammation of the thumb tendon has also spread to the tendon sheath and the tendon has become stuck to the tendon sheath. In this case, normal movement in the thumb can no longer be performed, which would lead to severe pain during the attempted movement, but also to severe movement impairments. The aim of the operation would be to expose the tendon sheath at the open wrist and to make the tendon running in it glide again.

After the surgical procedure, physiotherapy is urgently needed as soon as possible to prevent stiffening of the muscle. In most cases, however, a conservative treatment is sufficient to cure an inflammation of the tendon of the thumb. After the diagnosis of an inflammation of the tendon of the thumb, immediate and consistent immobilization of the thumb is urgently necessary.In most cases, this can only be achieved if an appropriate bandaging is applied.

Elastic bandages wrapped over the thumb and adjacent parts of the hand are usually sufficient. There are also treatment approaches where taping is used. This procedure, which is particularly well-known in orthopedics and trauma surgery, is intended to ensure that the forces normally acting on certain muscles are transferred to other healthy muscles.

In the case of tendinitis of the thumb, a short tape would be applied exactly over the affected muscle. The tape, also known as kinesiotape, is an elastic and self-adhesive tape that should be applied to the affected muscle areas without pulling. It is also important that the skin to which the tape is stuck is dry and non-greasy so that the tape does not slip.

The exact effectiveness of a kinesiotape has not been scientifically proven. However, there are many advocates, both on the patient and the practitioner side, for the treatment of various muscular diseases with a Kinesiotape. While a Kinesiotape has the task of relieving the affected muscle by diverting the forces to other muscles, a bandage is used for compression and immobilization.

The most important conservative measure in the case of tendonitis of the thumb is the consistent immobilization of the muscle. Since the thumb, the most important part of the hand, is automatically used for every movement in everyday life, immobilization is usually only possible with a bandage. Bandaging is achieved by using an elastic bandage.

A special wrapping technique is used to wrap the entire thumb (the tip of the thumb remaining free) up to the base of the thumb and beyond to the wrist. It is important to ensure that a still pleasant, but clearly perceptible pull and pressure through the bandage rests on the hand. The thumb should still be able to move slightly at the tip, but should be clearly restricted in movement in the area of the thumb joint.

It has been proven that in the case of muscular or joint problems, constant but still pleasant pressure on the affected joint, muscle or tissue leads to faster healing and a reduction in pain. Sometimes it may be necessary for the tendon inflammation of the thumb to be so severe that complete immobilization of the thumb is required. While parts of the tip of the thumb and the metacarpophalangeal joint of the thumb are still mobile during bandaging and can halfway maintain movement in the hand, complete immobilization of the thumb without any freedom of movement can only be achieved by splinting.

For splinting, a rigid splint, which is usually made of plastic today, is taken and the thumb is placed on it. The thumb is then fixed in place with an elastic bandage which presses the thumb against the splint and thus makes it completely immobile. A splint can remain on the thumb for a few days to a few weeks.

From time to time the splint should be removed by the examiner and the thumb should be examined thoroughly. If the pain of the thumb has improved significantly under a splint, it may be considered to remove the splint and slowly train the thumb. Even after surgery, severe tendonitis of the thumb and after tendon sheath adhesion, the thumb is usually splinted for 1-2 days to achieve faster healing.

Besides ointments and tablets, there are also some homeopathic approaches that have an anti-inflammatory effect on muscles and joints in the hand and thumb area. In order to choose the right homeopathic medication, many diagnostic questions are often necessary, which the homeopathic working doctor asks the patient. For example, whether the pain in the joint is accompanied by other symptoms, whether it is accompanied by restlessness or burning, etc.

Then the appropriate anti-inflammatory medication is selected, which is then taken in the form of globules. Globules are small globules that should sometimes be taken every 30 minutes, sometimes less frequently during the day. Often, after several days of taking them, the basic symptoms worsen before the actual healing process begins.

In case of an inflammatory disease in the area of the thumb and thumb joint, Arnica montana and Ruta graveolens would be used. Although there is still a complete lack of scientific proof of an effect with homeopathic medicines, homeopathic medicine has become established as an accompanying and recognized treatment even in orthodox medicine. In addition to the consistent immobilization of the thumb, attempts can also be made to accelerate the healing of tendonitis with cooling and anti-inflammatory ointments and gels.Primarily ointments and gels containing an anti-inflammatory agent are used for this purpose.

Ibuprofen gel (DocGel) or diclofenacgel (Voltaren®) would be the most commonly used. It is also possible to perform a treatment with kyttasalve, which also has a slightly anti-inflammatory and cooling effect. If the ointment or gel is applied to the skin, the base of the thumb up to the wrist should be covered with the ointment.

The tip of the thumb can remain free. For better protection, an elastic bandage should then be wrapped over the thumb. An ointment or gel treatment can be repeated several times a day to achieve a correspondingly higher treatment effect.

Surgical treatment of tendonitis is usually only used if either conservative treatments have not helped and or the inflammation of the thumb tendon has spread so much that there is already adhesion between the tendon sheath and tendon. In this case, under sterile conditions and through an incision at wrist level, an access is made to the glued and inflamed thumb tendon and the tendon sheath is opened. The glued and inflamed thumb muscle that runs in it is then loosened and mobilized until it can slide back and forth in the tendon sheath in a normal way.

Then both the tendon and the wrist are closed again. In the meantime, there are also some minimally invasive surgical techniques (keyhole technique) that allow access to the affected tendons through tiny incisions and enable mobilization of the tendons in the tendon sheath. After the operation, the thumb is usually splinted for 1-2 days before the necessary physiotherapy to mobilize the thumb muscle can begin.