De Quervain’s Tenosynovitis (DQT) causes significant pain and tenderness along the thumb-side of the wrist, making simple actions like gripping and pinching difficult. While professional splinting or physical therapy offers structured treatment, wrapping the wrist provides temporary relief and support through self-applied immobilization. This guide details a specific wrapping method using flexible, supportive tape to manage symptoms at home by limiting painful movements and reducing mechanical stress on the affected tendons.
Understanding the Goal of Wrist Wrapping for De Quervain’s
The primary purpose of wrapping the wrist for DQT is to create a mechanical barrier that limits specific, painful joint movements. This condition involves irritation of the Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB) tendons, which share a narrow sheath on the radial (thumb) side of the wrist. When the wrist moves toward the pinky finger (ulnar deviation) or the thumb extends forcefully, these tendons rub against the sheath, causing friction and inflammation. A well-applied wrap, particularly using elastic kinesiology tape, aims to prevent the extreme ranges of motion that provoke this friction. By supporting the joint and limiting these specific aggravating movements, the wrap reduces mechanical stress on the first dorsal compartment, allowing the inflamed tendon sheaths to rest and begin the healing process.
Gathering Materials and Preparation
Successfully wrapping the wrist begins with gathering the correct materials and preparing the skin for application. Kinesiology tape, often sold in rolls of two-inch width, is preferred because its elasticity provides support without the rigid immobilization of a traditional splint. You will need a good pair of scissors, and a skin-prep wipe is helpful to ensure the area is clean and free of oils.
Before cutting any tape, the skin over the wrist and forearm must be thoroughly cleaned and dried to maximize the adhesive’s grip. The corners of every strip of tape should be rounded with scissors after cutting, as this simple step significantly reduces the likelihood of the edges catching and peeling off. For application, the wrist and thumb should be positioned to gently slacken the target tendons, typically meaning slight extension and radial deviation, holding the thumb in a relaxed, slightly extended position.
Step-by-Step Guide to Applying the Wrap
The wrapping technique utilizes two primary strips of kinesiology tape to achieve targeted support for the APL and EPB tendons.
Applying the First Strip (Support)
Measure the first, longer strip from the base of the thumb, near the knuckle, up the forearm toward the elbow. Cut this strip slightly shorter than the measured length to account for the necessary stretch during application. To apply the first strip, tear the paper backing at one end and anchor the tape’s base with zero stretch just below the thumb’s first joint. Keeping the hand in the prepared position, gently pull the tape up and over the painful radial side of the wrist. Apply a light to moderate stretch (30% to 50% of maximum elasticity), following the line of the forearm. The end of this strip should be laid down on the forearm, again with zero stretch, which prevents the ends from peeling up quickly.
Applying the Second Strip (Decompression)
The second strip is shorter and is used to create a decompression anchor over the most painful point, usually the radial styloid process. Measure this strip to wrap about two-thirds of the way around the wrist. Tear the paper backing in the center, exposing the adhesive, and apply the exposed center directly over the area of maximum tenderness. This center section is applied with a higher degree of stretch (50% to 75%) to provide maximum lift and decompression. Once the center is adhered, remove the remaining paper backing on one side and lay the end down around the wrist, ensuring the last inch or two is applied with zero stretch. Repeat this process for the other side, laying the final anchor down with no tension. After both pieces are applied, rub the entire application firmly for several seconds to activate the heat-sensitive adhesive, securing the wrap to the skin.
Wear Time, Safety, and When to Seek Medical Advice
Kinesiology tape is designed to be worn for an extended period, typically remaining effective for two to five days, even through showering. The exact duration depends on the quality of the tape, the preparation of the skin, and the amount of friction the wrap encounters during daily activity. When the tape begins to peel or the edges roll up, it is time to remove and reapply a new wrap if symptoms persist.
Safety and Removal
It is imperative to monitor the hand and fingers for signs that the wrap is too tight, which can indicate restricted circulation. Immediate removal is necessary if you experience numbness, tingling, or a noticeable change in skin color, such as a blue tint or excessive paleness in the fingertips. The wrap should feel supportive, but it should never cause pain or restrict blood flow. To remove the tape, peel it back slowly in the direction of hair growth, pressing down on the skin behind the tape to prevent irritation.
When to Seek Medical Advice
While self-wrapping offers temporary symptom relief, it is not a substitute for professional medical care. If the pain and swelling do not improve significantly within a week of consistent wrapping and activity modification, or if the pain is disabling, a professional evaluation is necessary. A healthcare provider can confirm the diagnosis and discuss other conservative treatments like custom splinting, corticosteroid injections, or formal hand therapy.