Introduction
De Quervain tenosynovitis is the most common cause of lateral wrist
pain. It occurs with stenosis of the abductor pollicis longus and
extensor pollicis brevis tendons in the first dorsal extensor
compartment of wrist. Thumb extension occurs with the contraction of
these muscles, which is why thumb extension and ulnar deviation
exacerbates pain. The prevalence of De Quervain tenosynovitis has been
reported to be 0.5% in males and 1.3% in females.1,2 It is seen more commonly in middle-aged females
and in the dominant hand. In De Quervain tenosynovitis, fibrous tissue
deposits cause thickening of the tendon sheaths, but the cause of these
fibrous tissue deposits is unclear.
Diagnosis of De Quervain tenosynovitis is based on clinical examination.
The diagnosis can be made with the Finkelstein test, in which pain is
provoked with wrist ulnar deviation.3,4 Plain
radiography may be useful for differential diagnosis. Conservative
treatment of rest, non-steroidal anti-inflammatory drugs (NSAID), and
physical therapy is applied first, then there may be a need for
corticosteroid injections, and in resistant cases,
surgery.5 In some resistant cases, complementary and
alternative methods are preferred, as in other chronic musculoskeletal
diseases.6-9
Neural therapy (NT) is a regulatory therapy using local anesthetics for
the management of chronic musculoskeletal pain. Neural therapy resolves
the underlying autonomic dysregulation by regulating the autonomic
nervous system. It occurs through the membrane stabilizing effect of
local anesthetic agents used during neural therapy. As a result of
autonomic regulation, tissue perfusion increases, pain mediators are
removed, and it provides an anti-inflammatory effect. Neural therapy
targets painful areas, segments of these areas and trigger points, so
includes local therapy (infiltration of trigger points) and segmental
therapy (infiltration of sympathetic ganglia, nerve roots, or peripheral
nerves).10,11
To the best of our knowledge, the effect of neural therapy on patients
with De Quervain tenosynovitis has not been previously evaluated.
Therefore, the aim of this study was to highlight the short and
long-term effects of neural therapy on this condition.