Journal of Physical Therapy and Health Promotion
Journal of Physical Therapy and Health Promotion(PTHP)
Frequency: Annually
Effectiveness of Therapeutic Ultrasounds on Postpartum De Quervain’s Tenosynovitis: A Randomized Controlled Trial
Lactating women have been reported to be at higher risk for De Quervain’s tenosynovitis. However, there is no consensus on the conservative treatment of this disease, which differs based on the severity of its signs and symptoms. This study was performed to investigate the effectiveness of ultrasound therapy in women with postpartum De Quervain’s disease. A randomized, placebo-controlled, double-blind study was designed. Twenty lactating women between 20 and 25 years of age with De Quervain's tenosynovitis, enrolling in the study were randomly assigned into two groups including continuous ultrasound and placebo ultrasound. Patients were evaluated at baseline and at the end of the treatment by a visual analog scale and thumb pinch strength (Tip, Key and Palmar pinch strength). Pre-intervention showed no significant differences between the study and control groups’ pain scores and thumb pinch strengths (p>0.05). After 4 weeks’ intervention, the study group showed a decreased pain score compared to the control group (p< 0.05). Also observed was an increase and significant differences for all thumb pinch strengths (p<0.05) in the study group. In the control group, no differences were observed in the pain scores or thumb pinch strength between pre- and post-intervention (p> 0.05). The ultrasound therapy was effective in promoting reduction of wrist pain and improving the function status of the affected hand in lactating women with De Quervain’s tenosynovitis.
Keywords:De Quervain's disease; Ultrasound; Postnatal; Therapy
Author: Fayiz El-Shamy,Magda Morsy


  1. A. C. Retig, “thletic injuries of the wrist and hand. Part II: overuse injuries of the wrist and traumatic injuries to the hand,” Sports Med., vol. 32(1), pp. 262–273, 2004.
  2. S. Avci, C. Yilmaz, and U Sayli, “Comparison of nonsurgical treatment measures for de Quervain’s disease of pregnancy and lactation,” J Hand Surg., vol. 27(2), pp. 322–324, 2002.
  3. M. Anderson, and C. J. Tichenor, “A patient with de Quervain’s tenosynovitis: a case report using an Australian approach to manual therapy,” Phys Ther., vol. 74(4), pp. 314–326, 1994.
  4. A. M. Ilyas, M. Ast, A. A. Schaffer, and J. Thoder, “De Quervain tenosynovitis of the wrist,” J Am Acad Orthop Surg., vol. 15(12), pp. 757–764, 2007.
  5. T. A. Lamphier, N. G. Long, and T. Dennehy, “De Quervain’s disease: an analysis of 52 cases,” Ann Surg., vol. 138(6), pp. 832–841, 1953.
  6. J. M. Wolf, R. X. Sturdivant, and B. D. Owens, “Incidence of de Quervain’s tenosynovitis in a young, active, population,” J Hand Surg., vol. 34(1), pp. 112–115, 2009.
  7. N. Sakal, “Hand pain attributed to overuse among professional pianists: a study of 200 cases,” Med Probl Perform Artists, vol. 17(4), pp. 178–180, 2002.
  8. S. Bystrom, C. Hall, T. Welander, and A. Kilbom, “Clinical disorders and pressure-pain threshold of the forearm and hand among automobile assembly line workers,” J Hand Surg Br., vol. 20(6), pp. 782–790, 1995.
  9. M. Simmer-Beck, K. K. Bray, B. Branson, A. Glaros, and J. Weeks, “Comparison of muscle activity associated with structural differences in dental hygiene mirrors,” J Dent Hyg., vol. 80(1), pp. 8, 2006.
  10. K. M. Backstrom, “Mobilization with movement as an adjunct intervention in a patient with complicated de Quervain’s tenosynovitis: a case report,” J Orthop Sports Phys Ther., vol. 32(2), pp. 86–97, 2002.
  11. L. Reinstein, “De Quervain’s stenosing tenosynovitis in a video games player,” Arch Phys Med Rehabil., vol. 64(9), pp. 434–435, 1983.
  12. E. Carr, “An ergonomic case study of a person with de Quervain’s tenosynovitis relating to the use of a mobile phone,” Br J Hand Ther., vol. 8(4), pp. 128–133, 2003.
  13. Y. Roquelaure, C. Ha, A. Leclerc, A. Touranchet, M. Sauteron, and M. Melchior, “Epidemiologic surveillance of upper extremity musculoskeletal disorders in the working population,” Arthritis Rheum., vol. 55, pp. 765-778, 2006.
  14. H. Skoff, “Postpartum/newborn De Quervain’s tenosynovitis of the wrist,” Am J Orthop., vol. 30, pp. 428-430, 2001.
  15. N. Laoopugsin, and S. Laoopugsin, “The study of work behaviours and risks for occupational overuse syndrome,” Hand Surg., vol. 17, pp. 205-212, 2012.
  16. C. A. Jaworski, M. Krause, and J. Brown, “Rehabilitation of the wrist and hand following sports injury,” Clin Sports Med., vol. 29(1), pp. 61–80, 2010.
  17. A. C. Rettig, “Wrist and hand overuse syndromes,” Clin Sports Med., vol. 20(3), pp. 591–611, 2001.
  18. T. H. Huang, C. K. Feng, Y. W. Gung, M. W. Tsai, C. S. Chen, and C. L. Liu, “Optimization design of thumb spica splint using finite element method,” Med Bio Eng Comput., vol. 44(12), pp. 1105–1111, 2006.
  19. C. Peters-Veluthamaninal, J. C. Winters, K. H. Groenier, and B. Mayboom-deJong, “Randomized controlled trial of local corticosteroid injections for de Quervain’s tenosynovitis in general practice,” BMC Musculoskel Disorders., vol. 10, p. 131, 2009.
  20. M. J. Walker, “Manual physical therapy examination and intervention of a patient with radial wrist pain: a case report,” J Orthop Sports Phys Ther., vol. 34(12), pp. 761–769, 2004.
  21. L. B. Lane, R. S. Boretz, and S. A. Stuchin, “Treatment of de Quervain’s disease: Role of conservative management,” J Hand Surg Br., vol. 26(3), pp. 258–260, 2001.
  22. K. Knobloch, A. Gohritz, M. Spies, and P. M. Vogt, “Neovascularisation in de Quervain’s disease of the wrist: novel combined therapy using sclerosing therapy with polidocanol and eccentric training of the forearms and wrists-a pilot report,” Knee Surg Sports Traumatol Arthrosc., vol. 16(8), pp. 803–805, 2008.
  23. Carpenter D., Physicians drug handbook, Spring house, Pennsylvania, 9th Ed, PP. 301, 1167, 2001.
  24. S. A. Mehdinasab, and S. A. Alemohammad, “Methylprednisone acetate injection plus casting versus casting alone for the treatment of de Quervain’s tenosynovitis,” Arch Iran Med., vol. 13(4), pp. 270–274, 2010.
  25. P. M. Foye, W. J. Sullivan, A. Panagos, J. P. Zuhosky, A. W. Sable, and R. W. Irwin, “Industrial medicine and acute musculoskeletal rehabilitation. Upper- and lower-limb injections for acute musculoskeletal injuries and injured workers,” Arch Phys Med Rehabil., vol. 88(3), pp. S29–33, 2007.
  26. T. L. Hartzell, R. Rubenstein, and M. Herman, “Therapeutic modalities—an updated review for the hand surgeon,” J Hand Surg., vol. 37, pp. 597–621, 2013.
  27. S. L. Collins, R. A. Moore, and H. J. McQuay, “The visual analogue pain intensity scale: what is moderate pain in millimeters?” Pain, vol. 72, pp. 95–97, 1997.
  28. J. D. Rees, N. Maffulli, and J. Cook, “Management of tendinopathy,” Am J Sports Med., vol. 37, pp. 1855-1867, 2009.
  29. H. Sari, S. Tuzun, and K. Akgun, “Hareket Sistemi Hastaliklarinda Fiziksel Tip Yontemleri. İstanbul, Turkey: Nobel Tip Kitabevi; 2002 (in Turkish).
  30. M. C. Leung, “Effect of ultrasound on acute inflammation of transected medial collateral ligaments,” Arch Phys Med Rehabil., vol. 85, pp. 963-966, 2004.
  31. H. Shah, and B. Dongre, “A study to determine the effect of ultrasound and phonophoesis in de Quervain’s tenosynovitis,” Indian j of physiotherapy and occupational therapy, vol. 8(2), pp. 224-229, 2014.
  32. J. M. Fedorczyk, “Tendinopathies of the elbow, wrist, and hand: histopathology and clinical considerations,” J Hand Ther., vol. 25(2), pp. 191–200, 2012.