Relieving Tenderness Over Anatomical Snuff Box Through Penetration Enhancing Vehicles

Abstract

Introduction-De Quervain's tenosynovitis is caused by inflammation of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) tendons, which pass through the first dorsal compartment at the radial styloid. Patients who have this stenosing tenosynovitis usually describe tenderness in the anatomical snuff box and swelling proximal to the radial styloid process as well as pain in the wrist and on the lateral side of the hand .Retention of fluid has been suspected as an initiator of this problem, which appears to be significantly more common in women. Interestingly, many women suffer from de Quervain tenosynovitis during pregnancy or the postpartum period. This study was carried out to investigate the efficacy of ketoprofen phonophoresis (ultrasound mediated topical drug penetration enhancer) in the treatment of de Quervain's tenosynovitis during pregnancy.Methods -This study was carried out on thirty volunteer pregnant women in the 3 rd trimester complaining of dequervain's tenosynovitis of the dominant hand. The patients were divided into 2 groups equal in numbers. Group (A) received ultrasound therapy using Fastum gel (ketoprofen 2.5%) as a coupling medium. Group (B) served as a control group and received placebo (KY inert gel) with ultrasound therapy. Each patient was treated for 4 weeks .Assessment of pain intensity for each subject was done before and after the four weeks of treatment through Present pain intensity (PPi) scale.Results-The intervention group showed remarkable recovery in the form of reduction in pain. (p<0.005)Conclusion-From the statistical point of view it can be concluded that ketoprofen phonophoresis has an excellent effect on relieving pain of de Quervain's tenosynovitis during pregnancy that physiotherapists should confidently be able to use it in treating such cases.