An exploration of the use of Kinesio taping, long thumb spica orthosis (splint) and corticosteroid injections as a nonsurgical approach for treating DeQuervain’s tenosynovitis

Background: DeQuervain's Tenosynovitis is a painful and incapacitating condition that affects the tendons on the radial side of the wrist [the abductor pollicis longus (APL) and extensor pollicis brevis (EPB)]. Splinting, corticosteroid injections and nonsteroidal anti-inflammatory medications (NSAIDs) are examples of traditional treatment approaches. Kinesio tape has gained popularity in recent years as a viable treatment option for treating musculoskeletal injuries. The aims of this study were (i) to compare the efficacy of Kinesio tape in treating DeQuervain’s Tenosynovitis to that of a long thumb spica orthosis (splint) and (ii) to gain deeper insights into how and why clinicians make decisions about their interventions in the treatment of DeQuervain’s Tenosynovitis. Methods: A mixed methodology approach was used. A feasibility study was conducted to evaluate the likelihood of implementing a randomised clinical trial and to minimise unnecessary procedures. In addition, an online survey and focus groups were undertaken to provide an initial broad view of current practise and a comprehensive understanding of how practitioners thought or believed about DeQuervain’s Tenosynovitis treatment options and selection. Results: The results of the feasibility study showed that, due to recruitment challenges and COVID-19 restrictions, it was not feasible to conduct a randomised clinical trial. The survey findings highlighted that the most common conservative treatments used in clinical practice were long thumb spica orthosis (splint), a combination of Kinesio tape and long thumb spica orthosis (splint) and Kinesio tape. Further, the combination of steroid injection and a long thumb spica orthosis (splint) was considered the most effective treatment for DeQuervain’s Tenosynovitis according to the health-care professionals surveyed. The focus groups provided a deeper understanding and insight into practitioners' beliefs and decision-making regarding DeQuervain's Tenosynovitis treatment options. Moreover, these focus groups revealed factors influencing treatment choice, the implications of different treatment options, considerations of patients' needs and preferences, the roles of therapists in the treatment process and the importance of clinical judgement and justification. Conclusion: The current study contributes to the existing literature and lays the groundwork for future investigations into the efficacy of Kinesio tape as a treatment for DeQuervain's Tenosynovitis. The protocol proposed in the feasibility study exhibits promising potential for future research. Moreover, this study makes a valuable contribution to evidence-based practice by offering insights into the complex factors that influence clinicians' clinical reasoning and decision-making in the treatment of DeQuervain's Tenosynovitis.

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University of Galway

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Attribution-NonCommercial-NoDerivatives 4.0 International

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University of Galway Theses (PhD Theses)