De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a condition that occurs with the inflammation of the tendon sheath and tendons around the base of the thumb causing pain in the wrist and thumb. If you have this condition, you will feel pain while turning your wrist, or making a fist or grasping anything. Any activity that involves repetitive hand or wrist movement, such as playing golf, lifting a baby, gardening, can cause de Quervain’s Tenosynovitis. However, the exact reason for the condition is still unknown.

The condition is also called de Quervain’s syndrome or de Quervain’s disease. If left untreated, it can lead to further issues.

Causes

• Overuse
• Pregnancy
• Rheumatoid Arthritis

Symptoms

• Swelling
• Snapping sensation while the movement of the thumb
• Continuous pain in wrist and thumb
• Inability to move wrist and thumb

Diagnosis

Your orthopedist will carry out a physical examination of your hand to check for painful areas. He may also perform the Finkelstein test – you bend your thumb toward the palm, along with the fingers folding down over your thumb. After this, you bend your wrist in the direction of the little finger. If you feel pain on the thumb side, you probably have de Quervain’s tenosynovitis.

The orthopedic specialist will also suggest some imaging tests, such as:

• X-Rays
• MRI
• CT-Scan

Treatment

Pain medications: You can take over-the-counter pain-killers like Naproxen and Ibuprofen to reduce pain and swelling.

Steroids: Your orthopedic specialist may inject steroids into the sheath, or tight covering of the tendon to control the symptoms.

Splint: You will be recommended to wear a splint, all day for around 4-6 weeks to hold your wrist and thumb in position.

Physical therapy: Your doctor will suggest you to practice simple exercises to strengthen your hand, wrist, and arm.

Surgery: When these treatment options don’t work, the tendon sheath needs to be operated to have smooth movement. It is an outpatient procedure, and after discharge you must perform the post-surgery exercises for complete recovery.

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