De Quervain’s tenosynovitis in patients with lymphedema: a report of 2 cases with management approach

Abstract

Lin JT, Stubblefield MD. De Quervain’s tenosynovitis in patients with lymphedema: a report of 2 cases with management approach. Arch Phys Med Rehabil 2003;84:1554–7. De Quervain’s tenosynovitis is a tendonitis of the abductor pollicis longus and extensor pollicis brevis tendons. It commonly occurs as a result of overuse and is often seen in patients who perform repetitive activities. The occurrence of de Quervain’s tenosynovitis in lymphedema has not been reported, nor has the management of de Quervain’s tenosynovitis been discussed in the literature for patients whose lymphedema results from cancer or other disorders. Musculoskeletal conditions in lymphedema patients often require special considerations because these patients are more susceptible to infections and other complications. We describe the rehabilitation management of de Quervain’s tenosynovitis in 2 patients with lymphedema secondary to breast carcinoma. Both patients responded to conservative management with a good clinical outcome. We conclude that a conservative initial management approach consisting of the continued wear of a compression garment, the fabrication of a custom-made thumb spica, occupational therapy with an emphasis on tendon gliding exercises, and prescription of a nonsteroidal anti-inflammatory drug is effective and safe.