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Wrist News

Pianists with de Quervain's Disease Play a Happy Tune

Have you ever heard of "washerwoman's sprain"? This painful condition of the hand and wrist was common 100 years ago among women who made a living washing clothes. Today, it goes by another name: "de Quervain's disease." The name has changed, but the problem remains the same.

Repetitive motions can bring on de Quervain's, especially a sideways motion of the wrist while gripping or using the fingers. This movement may cause painful irritation, swelling, and thickening of the tendons between the thumb and wrist.

Anyone using this motion can develop de Quervain's, but some people are more likely to get it than others. For example, assembly-line workers, musicians, skiers, and hairdressers are at risk. Women are affected 10 times more often than men. The reason for this may be differences in anatomy. Normally, there are two tendons that pass through a tunnel at the base of the thumb, called a compartment. Many women with this condition have a second compartment, one for each tendon. More contact around each tendon could explain why de Quervain's occurs more often in women.

Treatment for this condition involves rest, splints, and medication. Sometimes surgery is also needed. None of these options is acceptable to musicians though--especially professional pianists. Rest and splints are too time-consuming. And surgery alters the ability to play a full octave (stretching the little finger and thumb over eight keys).

An alternate treatment is the injection of corticosteroid medication into the affected area. In most cases, only one injection is needed. The pianist can usually return to work within three days. A second injection may be needed if pain and swelling persist. If a person has two compartments, the medication may not get to the sore tendon. The authors specifically injected the medication into the side of the thumb tendons within the compartment. Nearly all the patients in the study got relief after just one injection.

Pianists and other musicians do not have to give up their careers because of painful hand symptoms. When pain and swelling are caused by de Quervain's disease, treatment may be simple. A single injection of corticosteroid medication can return the player to the piano or other instrument in a matter of days. There are no major complications of this treatment, only happy musicians tickling the ivories.

Naotaka Sakai, MD, PhD. Selective Corticosteroid Injection Into the Extensor Pollicis Brevis Tenosynovium for de Quervain's Disease. In Orthopedics. January 2002. Vol. 25. No. 1. Pp. 68-70.


*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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