A 29 year old IT developer worked in a busy office with several colleagues. His job required him to work from the same corner desk which had two screens and one keyboard. He complained to his manager for several months of pain in his right thumb radiating up his forearm which was worse when he used the mouse or texted on his mobile phone.
His manager suspected a repetitive strain injury and requested that the firm's Risk assessor check over his employee's work station. He was issued with a supportive desk chair, a gel wrist support for the keyboard and an ergonomic mouse. He was signed off sick for 2 weeks by the company nurse and he felt confident the rest from work would sort out the problem.
As soon as he returned to work and began using the ergonomic adaptations provided to him, the original pain returned worse than ever. He attended his GP this time who diagnosed inflammation of the thumb tendons. The GP referred him to see a hospital consultant for injection therapy and possible surgery. The waiting list was 7-10 months and the GP signed him off work for a further 4 weeks.
The IT Developer was anxious to return to work soon because he hoped to have a promotion and so much sick leave was potentially limiting his career.
He attended Hand Kinetics and explained his symptoms. The therapist performed a full assessment and diagnosed
De-Quervain's tenosynovitis. It was found that movements he had been performing repeatedly every day in work and at home such as texting on a phone and clicking on a mouse were the main causes for his condition. Unfortunately, the condition had been aggravated by using the gel wrist support at his keyboard in work because it had put his thumb tendons into a stressed position.
His therapist immediately isolated the tendons involved in a supportive splint made at his first appointment to prevent any further tearing of the thumb tendon fibres. Due to the length of time elapsed since the start of symptoms, the tendon fibres had partially repaired incorrectly and needed to be remodelled to reduce inflammation and strengthen them. He had an intensive course of therapeutic ultrasound over 6 weeks to help speed up recovery. Within 3 days the pain had significantly reduced and he was able to return to work confident that his condition was mending properly.
After 6 weeks the splint was removed and rehabilitation of the muscles started. Specific exercises were taught for a further 3 weeks and the IT developer had no further problems.
