CLINICIAN EDUCATION:  Evaluation of thumb pain

CASE STUDY: Thumb Pain

SUBJECT:
Female patient who works as a PT who had bilateral DeQuervain release which helped pain. Post-op, she has restricted wrist flexion and ulnar deviations due to surgical scars. However, she is unable to perform scar tissue mobilization as she has severe hypersensitivity over the surgical incisions sites that would lead to severe pain and vomiting if contacted with even minimal pressure.

TREATMENT
Treatment #1:
Transverse spacing technique (50% tension) with Rocktape over left surgical incision. Resulted in able to perform myofascial release without producing symptoms in left hand.

Treatment #2:
Removed application from left wrist and applied longitudinal spacing technique to spine while in maximum spinal flexion. Resulted in able to perform myofascial release to wrists bilaterally without reproduction of symptoms.

RATIONALE
Diagnosis: central sensitization / reflexive sympathetic disorder

Spacing techniques are used as decompression applications. By placing over the spinal cord, there is a decrease in intrathecal pressure. It also provides decompression to the sympathetic nerve ganglion and the peripheral nerve roots.

(Note: picture is of the finished application but not of actual patient.)