The effects of taping on de Quervain's disease: A systematic review and meta-analysis.

BACKGROUND: Therapeutic taping may be a useful modality in relieving pain, improving strength, and restoring the function of patients with De Quervain's Disease (DQD). Evidence on the effectiveness of therapeutic taping for DQD patients in mitigating its clinical signs and symptoms is not established. However, reviews report Kinesio Taping effects on musculoskeletal pains not specific to DQD. METHODS: The study followed the guideline statement of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Two researchers (RD and SN) searched the electronic databases and hand-searched for relevant journals. The relevant articles were selected using keywords found in titles and abstracts and, consequently, full-text manuscripts. A third researcher (VCDIII) resolved the disagreements between the two researchers. They used Review Manager 5.4 for risk of bias assessment and meta-analysis. Data were pooled to determine the therapeutic taping's overall effect. Heterogeneity was assessed by Higgin's (I2) statistic. The random-effects model was used if heterogeneity was high (>60%). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Approach determined the certainty of evidence. RESULTS: Seven high-risk of bias clinical-controlled trials comprising 241 participants were included in the meta-analysis. The reported outcome measures were the Visual Analogue Scale (VAS) for pain, Patient-Rated Wrist/Hand Examination for Function and Power, and precision grip strength using a hand-held dynamometer and pinch gauge. Therapeutic taping did not improve the pain, power grip, grip strength, and function of participants with DQD (p > 0.05). Therapeutic taping compared to other physical therapy interventions did not reduce the VAS scores of 241 participants with DQD [SMD (95% CI) = -1.08 (-2.55,0.39), p = 0.15]. Kinesio taping with low-level laser therapy compared to ultrasound and exercise did not improve the function of 60 participants with DQD [SMD (95% CI) = 0.56 (-4.71,3.60), p = 0.79]. Therapeutic taping compared to ultrasound and Mulligan Pain Releasing Phenomenon did not improve the power grip strength of 50 participants with DQD [SMD (95% CI) = 1.24 (-0.83,3.31), p = 0.24]. Therapeutic taping was not better than phonophoresis in improving the precision grip strength of 50 participants with DQD [SMD (95% CI) = 0.43 (-1.95,2.80), p = 0.72]. CONCLUSIONS: There is insufficient evidence to recommend the use of therapeutic taping in treating patients with DQD. Therapeutic taping was no better than other treatment modalities in mitigating the clinical signs and symptoms of DQD (p > 0.05). Therapeutic taping did not affect wrist pain, handgrip, pincer strength, and function of participants with DQD (p > 0.05).

Effectiveness and safety of moxibustion for De Quervain disease: A protocol for systematic review and meta-analysis.

BACKGROUND: De Quervain disease (DQD) is a common clinical disease. As a strainingdisease, DQD is more common in women who frequently engage in manual operations. The main clinical symptoms are local pain and dysfunction. Many clinical studies have reported that moxibustion has a good effect on the treatment of DQD, but there is no relevant systematic review. So the purpose of this study is to evaluate the effectiveness and safety of moxibustion in treating DQD. METHODS: The following 8 electronic databases will be searched, including PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, Chinese Scientific Journal Database (VIP), Wanfang Database, and Chinese Biomedical Literatures Database (CBM) from their inception to 1 October 2020 without any restrictions. Researchers retrieve the literature and extracted the data, evaluation of research methods, quality of literature. The outcomes will include a visual analogue scale, Finkelsteins, resisted thumb extension, total effective rate, incidence of any adverse events. We use the Cochrane Risk of a bias assessment tool to evaluate methodological qualities. Data synthesis will be completed by RevMan 5.3.0. RESULTS: We will show the results of this study in a peer-reviewed journal. CONCLUSIONS: This meta-analysis will provide reliable evidence for moxibustion treatment of DQD. INPLASY REGISTRATION NUMBER: INPLASY2020100111.

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)-Part II, elbow and wrist.

BACKGROUND: Although image-guided interventional procedures of the elbow and wrist are routinely performed, there is poor evidence in the literature concerning such treatments. Our aim was to perform a Delphi-based consensus on published evidence on image-guided interventional procedures around the elbow and wrist and provide clinical indications on this topic. METHODS: A board of 45 experts in image-guided interventional musculoskeletal procedures from the European Society of Musculoskeletal Radiology were involved in this Delphi-based consensus study. All panelists reviewed and scored published papers on image-guided interventional procedures around the elbow and wrist updated to September 2018 according to the Oxford Centre for Evidence-based Medicine levels of evidence. Consensus on statements drafted by the panelists about clinical indications was considered as "strong" when more than 95% of panelists agreed and as "broad" if more than 80% agreed. RESULTS: Eighteen statements were drafted, 12 about tendon procedures and 6 about intra-articular procedures. Only statement #15 reached the highest level of evidence (ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement). Seventeen statements received strong consensus (94%), while one received broad consensus (6%). CONCLUSIONS: There is still poor evidence in published papers on image-guided interventional procedures around the elbow and wrist. A strong consensus has been achieved in 17/18 (94%) statements provided by the panel on clinical indications. Large prospective randomized trials are needed to better define the role of these procedures in clinical practice. KEY POINTS: • The panel provided 18 evidence-based statements on clinical indications of image-guided interventional procedures around the elbow and wrist. • Only statement #15 reached the highest level of evidence: ultrasound-guided steroid wrist injections result in greater pain reduction and greater likelihood of attaining clinically important improvement. • Seventeen statements received strong consensus (94%), while broad consensus was obtained by 1 statement (6%).

Comparison between acupotomy and local steroid injection for the management of de Quervain disease: A systematic review protocol.

BACKGROUND: De Quervain disease (dQD) is a painful condition of the wrist that affects patients' quality of life and work ability. Acupotomy has been widely used in the treatment of dQD. It has been reported in many articles that acupotomy can improve the clinical symptoms of dQD. However, the efficacy has not been evaluated scientifically and systematically. The aim of this systematic review protocol is to evaluate the efficacy and safety of acupotomy treatment compared with local steroid injection in patients with de Quervain disease. METHODS: Relevant randomized controlled trials will be identified by searching 9 databases (PubMed, EMBASE, Cochrane Library, Chinese literature databases, the Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI], SinoMed, Technology Journal [VIP], and the Wanfang Database). Randomized controlled trials (RCTs) of Acupotomy for dQD patients will be identified independently by 2 reviewers by searching the databases from inception to October 2018. Clinical effects will be evaluated as the primary outcome. The VAS (visual analog scale) score will be assessed as a secondary outcome. RevMan V.5.3 will be used to perform a fixed effect meta-analysis, and the evidence level will be evaluated by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. Continuous outcomes will be presented as the mean differences or standard mean differences, while dichotomous data will be expressed as relative risks. RESULTS: This study will evaluate the effectiveness and safety of acupotomy in the treatment of de Quervain disease in RCTs with high-quality VAS and RM. CONCLUSION: This systematic review will provide evidence to judge whether acupotomy is an effective intervention for patients with de Quervain disease. PROSPERO REGISTRATION NUMBER: CRD42018108786.

Complex Regional Pain Syndrome-Type 1 Presenting as deQuervain's Stenosing Tenosynovitis.

AIM: To report the presentation of complex regional pain syndrome-1 (CRPS-1) as deQuervain's stenosing tenosynovitis (DQST). CASE REPORT: A 24-year-old woman presented with 3-year history of clinical diagnostic criteria (CDC) of CRPS-1. Conservative and surgical treatment for this as DQST had failed to relieve her. We diagnosed the problem as CRPS-1with CDC as inflammatory manifestations of a mechanical tendinoses of all her 5 digital tendons caused by movement of the fingers and hand tethered by agonist (flexor)/ antagonist (extensor) muscles in co-contraction. Ultrasound guided dry needling (USGDN) relaxed the muscles, replacing the abnormal agonist/antagonist co-contraction with normal agonist/antagonist coordination. Resolution of tendinoses reversed the inflammation causing the CDC. Six months later she leads normal personal and professional life, with reduction of scores of painDetect (from 21 to 5), Patient Health Questionnaire (from 13 to 4), Disability of arm, shoulder and hand from 70.8 to 25 and reversal of muscle abnormality characteristic of CRPS-1 on Musculoskeletal Ultrasonography (MSKUSG). CONCLUSION: We believe the primary pathology of CRPS-1 to be co-contraction of agonist (flexor)/antagonist(extensor) muscles of digits resulting in tendinoses akin to DQST. CDC of CRPS are actually inflammatory manifestations of tendinoses amenable to reversal by USGDN which also addresses the disability, a hallmark of CRPS.

Efficacy of acupuncture versus local methylprednisolone acetate injection in De Quervain's tenosynovitis: a randomized controlled trial.

There is no consensus on the management of De Quervain's tenosynovitis, but local corticosteroid injection is considered the mainstay of treatment. However, some patients are reluctant to take steroid injections. This study was performed to compare the efficacy of acupuncture versus corticosteroid injection for the treatment of this disease. Thirty patients were consequently treated in two groups. The acupuncture group received five acupuncture sessions of 30 minutes duration on classic points of LI-5, LU-7, and LU-9 and on ahshi points. The injection group received one methylprednisolone acetate injection in the first dorsal compartment of the wrist. The degree of disability and pain was evaluated by using the Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) scale and the Visual Analogue Scale (VAS) at baseline and at 2 weeks and 6 weeks after the start of treatment. The baseline means of the Q-DASH and the VAS scores were 62.8 and 6.9, respectively. At the last follow-up, the mean Q-DASH scores were 9.8 versus 6.2 in the acupuncture and injection groups, respectively, and the mean VAS scores were 2 versus 1.2. We demonstrated short-term improvement of pain and function in both groups. Although the success rate was somewhat higher with corticosteroid injection, acupuncture can be considered as an alternative option for treatment of De Quervain's tenosynovitis.

Acupuncture in De Quervain's disease: a treatment proposal.

De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the hand affecting the tendons of the abductor pollicis longus and extensor pollicis brevis, caused mainly by overuse. Conventional treatments include rest, immobilisation, oral anti-inflammatory drugs, corticosteroid injection and even surgery, but none of these is established as clearly effective. Acupuncture is rarely mentioned and the points suggested are rather general-regional, tender and ah shi points. Tendinopathy is almost always associated with problems in the relevant muscles and this paper calls attention to the correct identification and needling of the affected muscles, in order to increase the specificity of acupuncture treatment.

De Quervain's syndrome associated with osteopoikilosis: a case report and review of the literature.

Osteopoikilosis is a rare, usually asymptomatic, autosomal-dominant bone disorder, which is generally diagnosed incidentally on X-ray. De Quervain's syndrome is a disorder characterized by pain on the radial (thumb) side of the wrist, impairment of thumb function and thickening of the ligamentous structure covering the tendons in the first dorsal compartment of the wrist. In this case report, we present a young woman with De Quervain's syndrome associated with osteopoikilosis.

Estudo prospectivo randomizado comparativo do tratamento da doença de De Quervain com corticosteróide associado a terapias complementares / A randomized study comparing the treatment of de Quervain disease with corticosteroids associated with complementary therapies

Comparou-se três formas de tratamento para doença de De Quervain: somente infiltração com corticosteróide, infiltração com corticosteróide associada à imobilização com órtese e infiltração com corticosteróide associado à fisioterapia. O grupo submetido ao tratamento associado de infiltração e fisioterapia apresentou melhora clínica superior aos demais grupos, os quais mostraram resultados semelhantes e melhora clínica menos acentuada. Do total de pacientes, dezessete (23,8%) não se beneficiaram do tratamento clínico e foram encaminhados para procedimento cirúrgico. Conclusão: A associação terapêutica de corticosteróides e fisioterapia foi comprovadamente superior à utilização de infiltração com ou sem imobilização para pacientes portadores da doença de De Quervain (AU)

Estudo prospectivo randomizado comparativo do tratamento da doença de De Quervain com corticosteróide associado a terapias complementares

Comparou-se três formas de tratamento para doença de De Quervain: somente infiltração com corticosteróide, infiltração com corticosteróide associada à imobilização com órtese e infiltração com corticosteróide associado à fisioterapia. O grupo submetido ao tratamento associado de infiltração e fisioterapia apresentou melhora clínica superior aos demais grupos, os quais mostraram resultados semelhantes e melhora clínica menos acentuada. Do total de pacientes, dezessete (23,8%) não se beneficiaram do tratamento clínico e foram encaminhados para procedimento cirúrgico. Conclusão: A associação terapêutica de corticosteróides e fisioterapia foi comprovadamente superior à utilização de infiltração com ou sem imobilização para pacientes portadores da doença de De Quervain