Case Study 3

Pain in right thumb and wrist joint

Client:

  • Female
  • Had been seeing a physiotherapist for several weeks, but was not finding any positive results for her condition
  • Wearing a splint around thumb and wrist
  • Aged 60
  • Lives in North East Victoria
  • Actively cares for grandchildren and enjoys cooking

Issues:

  • Diagnosed with De Quervains Tenosynovitis, a painful irritation of the tendons of the thumb side of the wrist by her local GP
  • Patient indicated pain in her right thumb and wrist
  • Range of movement severely impacted, with inner right wrist swelling and tenderness
  • Restricted lateral thumb movements (unable to touch the tip of her thumb to other fingers)
  • Pain likely caused by repetitive work such as sideways movements whilst using the thumb to grip a utensil or tool
  • Pain and discomfort also impacted on her sleep
  • From the initial Bowen Therapy session, right shoulder, right hip, upper right arm, and turning rotation of her neck also presented issues. The patient’s right shoulder was also found to be approximately 1cm lower than her left

Treatment:

  • Patient engaged in four treatment sessions
  • For the sessions, the patient’s wrist splint was removed with the wrist being gently supported through the Bowen Therapy session
  • The first session focussed on her neck and shoulder which were identified to also be of concern. Bowen Therapy focused on basic body balance, and working on her right hip which was rotated slightly forward
  • Bowen Therapy techniques were made around the scapula, and over the rotator cuff, in the upper back and shoulder region
  • Shoulder and upper arm work followed and was supported through gentle forearm and some wrist support through gentle moves

Outcomes:

  • Patient indicated a difference in her thumb and wrist issues by the end of the first session
  • Over four visits, patient reported less restriction and swelling
  • Patient concluded her physiotherapy treatment, in favour of Bowen Therapy (although the BTFA promote partnering with other therapies for an allied approach to patient care, when appropriate).
  • Patient reported reducing pain over the course of four treatments, and was able to remove her splint during the day, eventually using a soft sleeve to retain warmth to that area
  • Patient reported
  • After four months patient reported no problems, throughout the day, and even when sleeping
  • Patient has been able to actively engage in more activities requiring wrist and hand mobility