What is de Quervain’s tenosynovitis?
De Quervain’s tenosynovitis is a painful condition that affects the tendons in the wrist. It occurs when the two tendons around the base of the thumb become swollen. The swelling causes the sheaths (casings) covering the tendons to become inflamed. This puts pressure on nearby nerves, causing pain and numbness.
The main symptom of de Quervain’s tenosynovitis is pain or tenderness at the base of the thumb and also pain going up a forearm. The pain may develop slowly or come on suddenly. It may get worse when you use your hand, thumb, or wrist. You may experience difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching. Some may feel a "sticking" or "stop-and-go" sensation in the thumb when moving it.
A direct blow to the thumb
Hobbies like gardening or racket sports
Inflammatory conditions like rheumatoid arthritis
Repetitive workplace tasks
Who is susceptible?
Anyone can get de Quervain's tenosynovitis. But these things make it more likely:
Age. Adults between 30 and 50 are most likely to get it.
Gender. Women are 8 to 10 times more likely to get it than men.
Motherhood. It often happens just after pregnancy; caused by lifting the baby repeatedly.
Motion. Moving your wrist over and over again, whether it’s for fun or for work.
Treatment for de Quervain's tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence. If treatment is started early, symptoms should improve within four to six weeks. If de Quervain's tenosynovitis starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breast-feeding.
Medications reduce pain and swelling. Using over-the-counter pain relievers, such as ibuprofen and naproxen may help. Or a doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.
Therapy for de Quervain's tenosynovitis may include immobilizing the thumb and wrist, keeping them straight with a splint or brace to help rest the tendons. Avoid repetitive thumb movements as much as possible and/or pinching with your thumb when moving your wrist from side to side. It also helps to apply ice to the affected area. You may also see a physical or occupational therapist. These therapists may review how you use your wrist and give suggestions on how to make adjustments to relieve stress on your wrists. Your therapist can also teach you exercises for your wrist, hand and arm to strengthen your muscles, reduce pain and limit tendon irritation.
Surgery may be necessary if your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure so your tendons can glide freely. Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.