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.