Introduction:
Intersection syndrome is a condition that causes pain and inflammation in the forearm, specifically at the intersection point where the tendons of the wrist and thumb extensor muscles cross over. Fortunately, most cases of intersection syndrome can be effectively treated without invasive procedures. In this article, I will explore the different stages of treatment for intersection syndrome and the available options, ranging from non-invasive methods to injections and surgery.
Stage 1: Conservative Management
The initial stage of treatment for intersection syndrome focuses on non-invasive approaches and typically lasts for about 2 to 3 weeks. During this period, it is important to allow the affected area to rest and heal. Patients are advised to modify their activities to avoid exacerbating the condition and may need to immobilize the forearm temporarily.
To alleviate pain, short-term use of anti-inflammatory medications may be necessary.
Additionally, various self-care techniques can help in this stage. Cryotherapy (cold therapy) can be applied to the affected area to reduce inflammation. To reduce swelling, it is advisable to elevate and compress the affected area. Also, using a splint or taping the forearm on the thumb side is recommended.
Stage 2: Rehabilitation and Regaining Function
After the initial rest period, patients can gradually transition to the second phase of treatment, which focuses on regaining function and returning to normal activities. This phase typically lasts for 4 to 6 weeks. Working closely with a physiotherapist is crucial during this stage to ensure a safe and effective recovery.
The rehabilitation program may include stretches, specific movements, and targeted strength training exercises. It is important to follow the guidance of a physiotherapist and avoid overexertion. Increasing the weight, repetitions, or distance by no more than 10% per week helps prevent recurring symptoms and promotes gradual healing.
Injection Therapies for Persistent Symptoms
If conservative management does not alleviate symptoms, injection therapies may be recommended. There are several options available, although the evidence supporting their effectiveness for intersection syndrome is limited.
Corticosteroid injections, which involve injecting a mixture of corticosteroid and anesthetic into the affected area using a needle, are commonly used. These injections provide relief within 10 days, but their long-term effectiveness is uncertain.
Prolotherapy, an alternative to corticosteroid injections, involves injecting a solution of dextrose, sterile water, and lidocaine into the affected area. Proponents believe that prolotherapy induces inflammation, leading to the release of growth factors and collagen deposition, which strengthen the tissues. However, more research is needed to determine its efficacy in treating intersection syndrome compared to cortisone injections.
Hydrodissection, a medical procedure where saline is injected in high volumes to break up tissues and reduce adhesions, is another option. However, there is currently no evidence supporting its effectiveness in treating intersection syndrome.
Surgical Intervention as a Last Resort
If all non-invasive methods and injections fail to resolve the symptoms of intersection syndrome, surgical intervention may be considered. Tenosynovectomy, which involves making longitudinal incisions of the extensor retinaculum over the second compartment, is a surgical procedure that can provide relief.
So, intersection syndrome can be effectively treated through a multi-stage approach, starting with non-invasive methods and progressing to injections or surgery if necessary. Most cases respond well to conservative management techniques, and patients can regain function with proper rehabilitation.
If you suspect you have intersection syndrome or are experiencing forearm pain reach out to your health practitioner to get the right diagnose and help manage the injury.