Tips For Travelling / De Quervain’s Tenosynovitis

Tips for Travelling

Travel has almost become a necessity of modern life. Many people travel for work, and most of us travel for pleasure at least once per year. Unfortunately, the hours of sitting involved in travel often also result in a stiff lower back, neck pain, and headaches. Below is a list of tips and tricks to avoid travel-related aches and pains:

Lower Back:

Lower back pain is the chief complaint of most car and plane travellers. To avoid low back pain, try the following tips:

1) Adjust the seat angle. If you are able, tilt the seat slightly down towards your feet, not towards your hips. Ideally, your knees should be level with your hips, or even slightly lower. A footrest to lift your knees can also help.

2) Adjust the seat back. To avoid compression through your lower back and pelvis, your seat should be upright, not tilted backwards. This will be more comfortable with implementation of tip #1, and aligns your whole spine.

3) Lift the height of the whole seat. This will assist with tip #1 by lifting the whole body away from the floor. When your hips are less bent, it is easier for your back to sit comfortably in an upright position.

4) Use a lower back support. Many cars nowadays come equipped with in-built lumbar supports. Often this support is a generic design and not fitted for your specific shape or height. A proper lumbar pillow, or even a rolled towel in the small of the back, can be more effective in maintaining the natural arch of your spine. This relieves pressure through your intervertebral discs, spinal ligaments, and spinal muscles.

Neck:

Neck discomfort is easier to improve when tips for lower back are implemented first. Some very easy tips to reduce neck pain are as follows:

1) Use a travel pillow. If travelling on an airplane, try wearing the pillow backwards or sideways. This assists in supporting the head in a slightly better position when you rest or sleep, which helps to reduce the stress placed on the muscles, ligaments and joints within the neck.

2) Every hour, perform 10 chin retractions (also called chin tucks). This is easiest to perform correctly if you sit tall and press your chin straight backwards, lengthening the back of your neck. Do not tuck the chin to the chest. This exercise stretches the small postural muscles at the base of the skull, relaxing them.

3) Keeping your eyes on the road, rotate your head side to side gently. Then tilt side to side gently. Performing any neck movements helps reduce the tension within the muscles from holding still for long periods of time.

The tips above are only suggestions. If you find they are helpful, continue performing them throughout your travels. However, if any of the above tips cause you pain or discomfort, it is advisable to seek your physiotherapist’s opinion. It is also advisable to stop for 15 minutes to stretch your legs and walk around every two hours when driving. When on a plane, refer to the guidelines written by the airline for prevention of deep vein thrombosis.

Focus On De Quervain’s Tenosynovitis

What is De Quervain’s Tenosynovitis?

De Quervain’s Tenosynovitis is a painful condition that affects two tendons on the thumb-side of the wrist. These tendons are responsible for moving the thumb sideways and backwards and sometimes become trapped as they pass through a small tunnel between the wrist and the thumb.
These tendons respond poorly to the extra compression and become sore to move and tender to touch. In some circumstances, the thickened, inflamed tissues may develop adhesions, or scarring, restricting movement of the thumb.

This condition affects many people, typically between the ages of 30 and 50. Women are affected 10 times more than men. Those affected include sportspeople who use rackets, bowlers, rowers, golfers, and canoeists. Manual labourers who perform repetitive duties are also commonly affected. De Quervain’s tenosynovitis is caused by a combination of overuse and overload factors.

Hormones during pregnancy can also contribute as they sometimes cause tendon swelling. New mothers often develop this condition while holding their newborn to breastfeed.

What are the signs and symptoms of De Quervain’s Tenosynovitis?

The hallmark symptoms of De Quervain’s Tenosynovitis are pain and swelling at the base of the thumb. These may develop suddenly, or over a period of time. The symptoms are made worse by activities requiring forceful gripping, pinching between the thumb and another finger, movement of the thumb, as well as twisting of the wrist.
To diagnose this condition, your physiotherapist will perform a Finkelstein’s test. This involves creating a fist with the hand, then tilting the hand away from the thumb. A positive result is pain on the thumb side of the wrist.

How can physio help?

Your physiotherapist is trained to effectively assess the condition and begin your rehabilitation. In most cases, you will be managed alongside a doctor as well. Typically, you will be immobilized in a splint for 3-4 weeks, which allows the inflamed tissues to rest and heal.
Hormones during pregnancy can also contribute as they sometimes cause tendon swelling. New mothers often develop this condition while holding their newborn to breastfeed.

What are the signs and symptoms of De Quervain’s Tenosynovitis?

The hallmark symptoms of De Quervain’s Tenosynovitis are pain and swelling at the base of the thumb. These may develop suddenly, or over a period of time. The symptoms are made worse by activities requiring forceful gripping, pinching between the thumb and another finger, movement of the thumb, as well as twisting of the wrist.
To diagnose this condition, your physiotherapist will perform a Finkelstein’s test. This involves creating a fist with the hand, then tilting the hand away from the thumb. A positive result is pain on the thumb side of the wrist.

How can physio help?

Your physiotherapist is trained to effectively assess the condition and begin your rehabilitation. In most cases, you will be managed alongside a doctor as well. Typically, you will be immobilized in a splint for 3-4 weeks, which allows the inflamed tissues to rest and heal.

In severe cases your doctor may request a corticosteroid injection to assist the inflamed tissues to heal. Following splinting your physio can help with other treatments including electrotherapies (ultrasound, TENS or interferential therapy), stretching, and a graduated strengthening program.
Other methods of treatment to improve function of the thumb and wrist include increasing grip size on objects (pens, steering wheel), improving mechanics of the hand in sports, and altering hand and arm position when cradling baby for breastfeeding.

If symptoms persist at 3 months, your physio and doctor can assist you in deciding if surgery is indicated. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

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