I have had De Quervain tenosynovitis in both wrists for years. I have been through thumb immobolizing braces, physical therapy, 2 injections (going for my 3rd tomorrow) hoping to get the doctor to agree to surgery.. the condition is extremely painful, it makes my wrists, hands, and fingers all very week. I certainly hope that I get some relief very soon. I am going into a career field soon, (almost finished with schooling for it) that may involve me lifting very heavy patients. I would feel terrible if I accidentally dropped them, not to mention they would take legal action.. all because my dr doesn't want to so surgery yet.
We found one controlled clinical trial of 18 participants (all pregnant or lactating women) that compared one steroid injection with methylprednisolone and bupivacaine to splinting with a thumb spica. All patients in the steroid injection group (9/9) achieved complete relief of pain whereas none of the patients in the thumb spica group (0/9) had complete relief of pain, one to six days after intervention ( number needed to treat to benefit (NNTB) = 1, 95% confidence interval ( CI ) to ). No side effects or local complications of steroid injection were noted.
Sounds like they had a DeQuervain’s injection (if it’s intratendinous instead of just under the tendon sheath there can be a lot of resistance…especially if using a tuberculin syringe/needle), and then had either a trigger thumb injection or an intraarticular injection of the 1st carpometacarpal joint. Either way, they shouldn’t have had “nerve damage” from either injection. The “nerve damage” was probably already there. Without a pre- and post-injection EMG/NCS, it’s impossible to know for sure. The skin atrophy and other signs can be relatively common with kenalog and other insoluble steroids. I don’t what the “thumb locking” is unless the patient means trigger thumb. Some physicians will use sterile saline injections in the atrophied area to speed up the recovery.