The abductor pollicis brevis (APB) muscle is what allows you to move your thumb away from your palm. Without it, you couldn’t grip things or give a thumbs-up!
Pain in this area is often chalked up to De Quervain’s tenosynovitis, but that’s not always the case. Other conditions can lead to abductor pollicis brevis pain.
This article will explore De Quervain’s, other potential causes of pain, what symptoms to look for, how doctors diagnose the problem, and the treatments that can help.
De Quervain’s Tenosynovitis: A Common Cause of APB Pain
Pain in the abductor pollicis brevis (APB) muscle can sometimes be traced to a common condition called De Quervain’s tenosynovitis.
What is De Quervain’s tenosynovitis?
De Quervain’s tenosynovitis is a painful inflammation of the tendons that control thumb movement. These tendons, the abductor pollicis longus and the extensor pollicis brevis, run along the thumb side of your wrist, through a small tunnel or sheath. If the tendons become inflamed, they swell, and that makes it harder for them to move smoothly inside the sheath, leading to pain and restricted movement.
Symptoms of De Quervain’s Tenosynovitis
Typical symptoms of De Quervain’s tenosynovitis include:
- Pain and swelling near the base of your thumb
- Trouble moving your thumb and wrist
- A “sticking” feeling when you move your thumb
- Pain that gets worse when you use your hand and wrist
Causes and Risk Factors
What causes the abductor pollicis brevis (APB) to become inflamed or painful?
Causes of De Quervain’s Tenosynovitis
- Repetitive hand and wrist motions, like gardening, hammering, or lifting
- Direct injury to your wrist or thumb
- Inflammatory arthritis
- Overuse injuries
Risk Factors for De Quervain’s Tenosynovitis
Certain factors can increase your risk of developing this condition:
- Age between 30 and 50
- Being female
- Pregnancy
- Repeatedly lifting a child
Diagnosing Abductor Pollicis Brevis Pain
A health professional can usually diagnose abductor pollicis brevis pain during a physical exam. One test they might use is the Finkelstein test, where they bend your thumb across your palm and then bend your wrist toward your little finger. If this causes pain, it might indicate De Quervain’s tenosynovitis, another condition that affects the tendons in your wrist.
Usually, imaging tests aren’t needed unless your doctor suspects something else might be going on.
Treatment Options for De Quervain’s Tenosynovitis
If you’re diagnosed with De Quervain’s tenosynovitis, there are several treatment options to consider, ranging from conservative measures to surgical intervention.
Non-Surgical Treatment Options
- Splinting or bracing the thumb and wrist can provide support and reduce movement, allowing the tendons to rest and heal.
- Avoiding repetitive movements or activities that worsen the pain is crucial.
- Physical therapy can include massage, heat or ice therapy, and targeted exercises to improve strength and flexibility. These exercises may involve isometric, eccentric, and concentric strengthening techniques.
- Rest is essential for allowing the inflammation to subside and the tendons to recover.
Steroid Injections
If non-surgical approaches don’t provide sufficient relief, your doctor might recommend injecting a local anesthetic and a steroid medication into the tendon sheath. This procedure typically involves cleaning the injection site and using ultrasound to guide the needle precisely.
Surgical Options
If conservative treatments and steroid injections fail to alleviate your symptoms, your doctor may discuss surgical release as an option. This procedure involves surgically releasing the tendon sheath to create more space for the tendons to move freely.
Summary
If you’re experiencing pain in your abductor pollicis brevis, it’s essential to seek medical attention as soon as possible to ensure the best possible outcome. Your treatment plan should be personalized to your specific needs and circumstances.
Be sure to follow your doctor’s instructions carefully and avoid any activities that worsen your symptoms.
Under the guidance of your healthcare provider, you might also explore treatment options like physical therapy to strengthen the affected muscles or steroid injections to relieve inflammation and pain.