Journal of Hand Therapy
Volume 22, Issue 3 , Pages 278-284, July 2009

Application of Mechanical Diagnosis and Therapy to a Patient Diagnosed with de Quervain's Disease: A Case Study

  • Shouta Kaneko, OTR

      Affiliations

    • Corresponding Author InformationCorrespondence and reprint requests to Shouta Kaneko, OTR, 4-5-3-9, Shinoro, Kita-ku, Sapporo, Hokkaido, Japan

Shinoro Orthopedic, 4-5-3-9, Shinoro, Kita-ku, Sapporo, Hokkaido, Japan

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia

Health and Wellbeing, Sheffield Hallam University, Sheffield, United Kingdom

published online 28 May 2009.

Abstract 

Study Design

Single case report.

Introduction

Mechanical diagnosis and therapy (MDT) is widely used in the management of both spinal disorders and extremity problems. However, there is no study that has introduced the application of this concept to hand therapy.

Purpose of the study

To demonstrate the application of MDT to a patient with a thumb problem, which was diagnosed as de Quervain's disease.

Methods

According to MDT principles, the thumb pain was assessed and treated.

Results

Radio carpal joint distraction with thumb metaphalangeal flexion combined with wrist ulnar deviation was found as the directional preference, which abolished the thumb pain. After the repeated movements Finkelstein test and tenderness to pressure became negative.

Conclusions

A patient apparently presenting with de Quervain's disease was classified as derangement syndrome using MDT. The pain was rapidly and successfully treated with self-management exercises.

Level of Evidence

4

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PII: S0894-1130(09)00027-1

doi:10.1016/j.jht.2009.03.002

Journal of Hand Therapy
Volume 22, Issue 3 , Pages 278-284, July 2009