Which is better for DeQuervain’s: Splinting or Injection?

Rapid Review 

Cavaleri, R., Schabrun, S. M., Te, M., & Chipchase, L. S. (2016). Hand therapy versus corticosteroid injections in de Quervain’s disease treatment: A systematic review and meta-analysis. Journal of hand therapy: official journal of the American Society of Hand Therapists, 29(1), 3–11. https://doi.org/10.1016/j.jht.2015.10.004

The Skinny: DeQuervain’s Tenosynovitis is a stenosing tenosynovial inflammation affecting the abductor pollicis longus and the extensor pollicis brevis in the 1st dorsal compartment. The treatment varies from conservative the surgical, and this review focuses on conservative treatment.

The authors performed a systematic review to compare the effectiveness of steroid injections with 1.) hand therapy splinting alone, 2.) hand therapy splinting with steroid injections, and 3.) steroid alone in treating DeQuervain’s.  

In the Weeds: A total of 6 articles were included in the review, which included 334 patients. The mean age of patients was between 27 and 44 years. Three studies compared steroid injections with splinting, and three compared splinting with injections alone. No studies were included that looked at other forms of therapy such as physical agent modalities, exercise, and manual therapy. The time the splint was worn was not specified in the studies. 

Bringing It Home: Both groups, including the corticosteroid injection and splinting group, improved overall function and decreased pain. More patients were treated successfully when combined splinting and steroid injection were used together.  

Rating: 4/5 The study’s limitations include the lack of specification on the type of splint used and the specific regime. The outcomes measures did not look at the quality of life; instead, they focused on treatment success rate and pain relief. Research into different treatment regimes is needed to make sound recommendations for splinting duration.