Medical Centric

DE QUERVAIN’S TENOSYNOVITIS

Men's Health, Women's Health / By

DE QUERVAIN’S TENOSYNOVITIS

De Quervain’s tenosynovitis is an inflammatory condition of the two tendons that control the movement of the thumb and their tendon sheath.

  • Tendons are strong, flexible bands of tissue attaching a muscle to a bone.
  • A tendon sheath is a layer of synovial membrane that permits the tendon to stretch and not adhere to the surrounding fascia.
  • This condition makes the movement of the thumb painful, causing pain at the thumb side of the wrist where the base of the thumb meets the forearm.
  • If you have the condition, it will probably hurt when you grasp anything, turn your wrist, or make a fist.
  • The condition may start gradually or start suddenly.
  • De Quervain’s tenosynovitis is more prevalent in women than in men especially during and after pregnancy.

CAUSES

The exact cause of the condition has not been established but it is believed that chronic use of the wrist is commonly associated with it.

Two tendons in the wrist and lower thumb glides smoothly through the small tunnel that connects them to the base of the thumbs when gripping, pinching, grasping, clenching, or wringing activities are carried out with the hands.

Rapid repetition of these motions daily may irritate the sheath around the tendons, causing inflammation that may restrict movements.

Specific activities that may increase the risk of the condition include intensive computer mouse use, typing, trackball use, sewing, knitting, playing piano, golf, and bowling.

Other causes may include:

  • Inflammatory conditions like rheumatoid arthritis
  • A direct blow or trauma to the thumb.

SYMPTOMS

  • Swelling near the base of the thumb
  • Pain near the base of the thumb, directly over the two tendons
  • Difficulty moving the thumb while performing activities that involve grasping or pinching
  • Swelling and pain on the side of the wrist
  • Pain that gets worse while trying to move the thumb or wrist
  • Reduced grip strength

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will check your hand to see if you feel pain when pressure on the thumb side of the wrist.

Then you’ll get the Finkelstein test. During this test, the doctor will ask you to bend your thumb across your palm and bend your fingers down over your thumb to make a fist. This movement helps your tendons to stretch. If it hurts on the thumb side of your wrist, you likely have the condition.

TREATMENT

The goal of treatment is to ease pain and inflammation, preventing movement in the thumb and preventing reoccurrence.

Treatment options may include:

  • Medications such as ibuprofen. The doctor may also recommend corticosteroid injection into the tendon sheath to reduce swelling.
  • Therapy which may include applying ice to the affected area, avoiding repetitive thumb movements, wearing a splint or brace that will hold your thumb firm and straight (worn for 24 hours a day for 4 to 6 weeks).
  • Surgery may be recommended for a more serious case. During the surgery, the doctor will inspect the sheath surrounding the affected tendon, and then open the sheath to reduce the pressure so the tendon can move smoothly. The surgical procedure is an outpatient procedure, which means you can go home afterward.