Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
De Quervain’s tenosynovitis is an inflammatory, painful situation which presents with swelling within the tendons across the thumb. It happens when the tendons develop into constricted inside their protecting sheath. It’s usually precipitated on account of repetitive thumb or wrist actions.
Thickening and degeneration of protecting tendon sheath across the thumb tendons, repetitive thumb or wrist actions and sudden traumatic harm to the wrist or thumb are the primary causes.
Predominant signs embrace ache and swelling within the thumb, tenderness, issue in transferring the thumb, numbness and popping or snapping sensation within the wrist.
Associated Studying – ‘De Quervain’s Tenosynovitis – causes, signs, prevention, remedy and Ayurveda Administration’
Ayurveda Understanding of De Quervain’s Tenosynovitis
Vata aggravation
De Quervain’s Tenosynovitis is a painful situation. Ache can’t happen with out the involvement of Vata. So, it qualifies to be referred to as as a situation attributable to aggravated vata within the area of the thumb.
Vata Vyadhi, Vatarakta and different circumstances to be thought-about in comparative examine
Hand and fingers or toes can be concerned within the painful circumstances attributable to vata and or rakta. So, this situation will be thought-about as one of many under talked about circumstances occurring or restricted solely to the area of the hand across the thumb and could also be involving the wrist joint –
– Vata Vyadhi
– Vatarakta
– Amavata
– Sandhigata Vata
– Shotha
– Kandaragata / Snayugata Vata
Tendon sheaths endure degeneration on this situation. That is led to by aggravated Vata. Fingers, toes and the joints of the limbs, together with the small joints of fingers and toes are additionally concerned in amavata, sandhigata vata or vatarakta. The pathogenesis ought to be understood on the premise of the signs of dosha or doshas that are predominant within the scientific image of the illness.
From the angle of causes
From the angle of causes additionally, it appears to be apt to incorporate it underneath Vata Vyadhi or Vatarakta. This situation is precipitated on account of repetitive use or actions occurring on the thumb joint or wrist joint or each. Vata and likewise rakta get aggravated by repetitive actions. This Vata might trigger degeneration of tendons or tendon sheaths, weaken the muscle tissue and joints therein and trigger ache and different circumstances. Swelling could also be precipitated on account of involvement of vata, rakta or kapha in numerous combos. Inflammatory swelling across the thumb and the tendons therein might recommend involvement of pitta and or rakta. Non-inflammatory swelling or oedema which can happen in later phases of the ailments mirror the involvement of kapha too.
From the angle of Signs
Signs additionally level in direction of involvement of Vata together with ache, tenderness, swelling, issue in actions, numbness and popping sensation. Any dosha would possibly get related to vata in the long term.
| Symptom of De Quervain’s Tenosynovitis | Dosha Involvement |
| Ache alongside the again / base of the thumb, over the affected tendons | Vata, Rakta, Ama |
| Swelling on the base of the thumb | Ama, Kapha, Vata, Rakta, Pitta |
| Tenderness | Vata, Rakta, Pitta |
| Issue in transferring the thumb / Catching sensation | Vata
Vata-kapha Vata-rakta |
| Numbness | Vata |
| Popping or snapping sensation | Vata |
| Fluid stuffed cyst | Kapha, Pitta / Rakta |
Indriya and Marma involvement
Since De Quervain’s Tenosynovitis is a painful situation which afflicts the thumb and hand, it’s clear from Ayurveda perspective that the karma indriya i.e. organ of motion ‘pani’ is affected. When this indriya is affected, one would discover it tough to handle the actions which are supposed to be executed by the fingers, together with greedy.
Tougher could be the actions and actions taking place by the hands if the marmas situated therein are affected. Kshipra Marma is the closest one for the thumb. When this marma is injured, it’s mentioned that akshepa – convulsions within the higher limb and marana – loss of life would ensue. Dying might right here be thought-about as loss of life of features and actions of the hand and higher limb. It’s a Kalantara Pranahara Marma i.e. that causes loss of life or destruction of actions step by step after being injured. De Quervain’s Tenosynovitis could be the impact of collective affliction or affect of harm of many Marmas within the neighborhood of the thumb – Talahridaya, Kurcha, Kurchashira and Manibandha Marmas together with Kshipra Marma. When there’s delayed therapeutic or reduction from signs or when there’s development of illness, worsening with time, despite well timed interventions, ought to draw our consideration in direction of the involvement of marmas of the hand.
Remedy rules
Nidana Parivarjana kinds a very powerful precept in treating De Quervain’s Tenosynovitis. The particular person has to stay away from overusing the thumb and hand and keep away from vata aggravating meals, behaviours and actions. Change in occupation too will be thought-about if it’s the trigger or set off for the issue.
Remedy of De Quervain’s Tenosynovitis primarily contains administration of Vata and treating primarily on the lies of Vata Vyadhi and Vatarakta. The opposite circumstances talked about above too shall be thought-about if the scientific photos of those circumstances match with Tenosynovitis.
The remedy rules of the illness which precisely correlates with De Quervain’s Tenosynovitis shall be adopted. The doctor can even take the freedom of planning the protocol of remedy after having correctly understood the pathogenesis and elements of pathogenesis of the illness from Ayurveda perspective. The rules shall be borrowed from totally different circumstances talked about above, as per Ayurveda and the remedy line designed.
If De Quervain’s Tenosynovitis is secondary to a foremost illness like Vatarakta or Vata Vyadhi, which most frequently is, it shall be handled on the traces of treating the primary illness.
The mainstays of symptomatic administration and likewise illness particular therapies could be –
Exterior –
– Abhyanga
– Dhara
– Lepa
– Upanaha
Inside – Shodhana
– Virechana
– Vasti
If the ache and different signs are cussed and never responding to traditional remedies, the involvement of Marmas in and across the thumb ought to be thought-about. They’re –
– Kshipra Marma
– Manibandha Marma
– Talahridaya, Kurcha and Kurchashira Marmas
Common administration of Vasti and Rasayanas are vital elements of the remedy on this context.
The remainder of the understanding of the illness and its administration ought to be on comparable traces as defined within the under talked about article.
Associated Studying – ‘Extensor Tendonitis – Ayurveda Understanding’
