Conservative Treatments
To reduce inflammation over the dorsal 1st compartment of the wrist/thumb it’s common for a forearm based thumb spica orthotic to be used. This allows the tendon to be immobilized, but at the same time allow the effected hand to be functional. It’s important to gently stretch the tendon into flexion, and utilize modalities such as heat and ice to help with discomfort. Ice is best used at the end of the day to reduce inflammation.
Injections
Corticosteroid injection is a more invasive form of conservative management, and is often combined with gentle stretching and immobilization of the thumb. This helps reduce inflammation of the effected tissues of the wrist and thumb, and the majority of individuals report improved symptoms within the first few days if they limit their activity and keep their thumb and wrist immobilized.
It can take up to 6 weeks for symptoms to subside completely. If symptoms don’t improve, then the doctor might discuss surgical intervention.
Surgical Intervention
Surgical intervention involves releasing the 1st dorsal compartment of the extensor retinaculum where the extensor pollicis brevis and abductor pollicis longus travel through. The surgeon will expose the extensor retinaculum, and simply make an incision that opens the 1st dorsal compartment. The surgeon leaves a flap large enough to prevent the tendons from subluxing from their place of origin after the surgery is performed.