De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is a relatively common condition we treat at the Hand Center of Louisiana. A painful condition in the hand and wrist, it can disrupt your daily activities and worsen over time if left untreated.
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What is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis is a painful debilitating condition that affects the tendons in your wrist nearest your thumb. If you have this condition, you’ll likely experience pain when making a fist, turning your wrist, or grasping an object.
What Causes De Quervain’s Tenosynovitis?
While the cause of de Quervain’s tenosynovitis remains unknown, repetitive hand or wrist movements can aggravate the condition. In fact, chronic wrist overuse is often associated with this condition.
When you grip anything with your hand, two tendons in your wrist and lower thumb move through a sheath that connects to the base of your thumb. Repetitive motions over time can irritate the sheath, causing it to swell and restrict the movement of the tendons.
Other causes of de Quervain’s tenosynovitis include:
- Rheumatoid arthritis or inflammatory arthritis
- Scar tissue from acute injury to your wrist or tendon
Signs and Symptoms of De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis may result in one or more of the following symptoms:
- Pain or swelling near the base of your thumb
- A “sticking” sensation in your thumb when moving it
- Difficulty moving your thumb and wrist when pinching or grasping
If left untreated, your pain may worsen in your thumb and wrist or spread to your forearm.
Diagnosis of de Quervain’s Tenosynovitis
To diagnose de Quervain’s tenosynovitis, your physician will apply pressure to the thumb side of your wrist to see if you experience pain.
Your physician will also ask you to place your thumb against your hand and make a fist with your fingers closed over your thumb. Then, you’ll bend your wrist toward your little finger. If you have de Quervain’s tenosynovitis, then you’ll feel pain on the thumb side of your wrist.
In most cases, diagnostic tests such as X-rays aren’t needed to diagnose the condition.
Treatment of de Quervain’s Tenosynovitis
Treatment for de Quervain’s tenosynovitis aims to reduce inflammation and preserve thumb movement while preventing recurrence.
For most people, getting early treatment can help improve symptoms in four to six weeks. For women who are pregnant, symptoms often remain until the end of pregnancy or breast-feeding.
Non-surgical treatments
Medication
Your doctor may recommend using over-the-counter pain relievers to reduce pain and swelling. Additionally, they may also recommend cortisone injections to reduce swelling in the tendon sheath. Most people fully recover from their symptoms when cortisone injections are used within the first six months of symptoms.
Therapy
Treatment of de Quervain’s tenosynovitis may include the following:
- Applying a splint or brace to immobilize your thumb and wrist
- Avoiding repetitive thumb motions
- Avoiding pinching when moving wrist side to side
- Applying ice or a cold pack to your thumb and wrist
Your physician may prescribe physical or occupational therapy. A Certified Hand Therapist will evaluate how you use your wrist and provide recommendations for alleviating stress and avoiding overuse. Your CHT can also guide you through exercises to reduce tendon irritation and pain, and strengthen your muscles.
Surgery
For more serious cases, your doctor may recommend outpatient surgery. This surgical procedure is commonly called “De Quervain’s release.” During the procedure, your doctor makes a small incision on your wrist, near the base of your thumb. Your physician will then inspect the sheath surrounding the tendon or tendons before releasing, or opening, the sheath to relieve pressure and friction on the tendon(s). This procedure typically takes less than an hour.
After surgery, your doctor will talk to you about rest, rehabilitation, and therapy, if appropriate.
Relieve Your Hand/Wrist Pain
De Quervain’s tenosynovitis is a common hand and wrist condition that can disrupt your daily activities. Like many hand conditions, it’s often caused by repetitive motions and chronic overuse your wrist; however, in some cases it may be a sign of a more serious condition such as rheumatoid arthritis. The condition can be treated through non-surgical and surgical methods. Once your condition is treated, you can experience a full recovery.
To find out if you have de Quervain’s tenosynovitis, contact us to schedule a consultation with one of our highly trained physicians specializing in treatment of hand and upper extremity conditions. They can diagnose your condition and help you find the best course of treatment for you.
TALK TO A PHYSICIANWhy Choose the Hand Center of Louisiana?
The Hand Center of Louisiana is the largest hand and upper extremity practice serving the Gulf South. Our award-winning practitioners operate at our state-of-the-art facility, which combines full-service medical evaluation and treatment, cutting-edge diagnostic and imaging capabilities, and onsite therapy services—all under one roof.