De Quervain’s tenosynovitis is a painful condition in which the extensor pollicis brevis and the abductor pollicis longus tendons become inflamed. These tendons are located within the first dorsal compartment of the wrist, on the thumb side of the forearm. Any hand injury or repetitive strain can cause inflammation and pain in these tendons. The tendon sheath that protects them can also become irritated, leading to the characteristic symptoms of de Quervain’s tenosynovitis. Direct injury to the wrist or thumb can also contribute to its development.
Although de Quervain’s tenosynovitis occurs most often in women, anyone can develop it. Orthopedic hand and wrist surgeons are the specialists who most often diagnose and treat de Quervain’s tenosynovitis, especially in complex cases.
Your Guide to De Quervain’s Tenosynovitis
Causes
Common causes and risk factors of de Quervain’s tenosynovitis include:
- Repetitive activities: Performing tasks that involve repeated motion of the thumb and hand, such as squeezing, pinching, or grasping, can lead to inflammation.
- Sports and overuse: Repetitive thumb and wrist movements, such as those involved in racquet sports, can strain the tendons.
- Overuse of the wrist and thumb: Excessive use of the wrist and thumb joints, particularly the carpometacarpal joint, can contribute to the condition.
- Untreated inflammation: If left untreated, de Quervain’s tenosynovitis can worsen, leading to increased pain and restricted motion.
- Arthritis: People with rheumatoid arthritis are more prone to developing de Quervain’s tenosynovitis.
- Pregnancy: Studies suggest an association between pregnancy and de Quervain’s tenosynovitis.
- Age: Middle-aged women are statistically more susceptible to this condition.
Symptoms
Common symptoms of de Quervain’s tenosynovitis include:
- Pain over the thumb or on the inside of the wrist
- Increasing pain when grasping or twisting the wrist
- Redness or swelling near the thumb and wrist
- A fluid-filled cyst in the affected area
- A snapping or catching sensation when moving the thumb
- Difficulty moving the thumb and wrist
- Pain radiating into the forearm or index finger
- Thumb triggering or stiffness
Diagnosis
Orthopedic hand and wrist specialists at OrthoTexas perform a physical exam to determine the severity of the condition and rule out other wrist or hand disorders such as intersection syndrome. X-rays may be used to distinguish de Quervain’s tenosynovitis from conditions affecting the carpometacarpal joint. The Finkelstein test is often performed to confirm the diagnosis. During this test, patients make a fist with the thumb placed inside the fingers and bend the wrist toward the little finger. Pain during this movement typically indicates de Quervain’s tenosynovitis.
Treatment
Treatment options for de Quervain’s tenosynovitis include:
- Rest: Avoid physical activities that strain the thumb and wrist.
- Ice: Apply ice packs to reduce swelling and pain.
- Medication: Anti-inflammatory medications may be prescribed to reduce inflammation and discomfort.
- Splinting: Using a splint to immobilize the thumb and wrist can promote healing.
- Corticosteroid injections: These may be used to decrease swelling and inflammation.
- Physical or occupational therapy: Therapy can help restore range of motion and strength.
- Surgery: In severe cases or when conservative treatments fail, surgery may be performed to relieve pressure on the tendons and restore smooth gliding within the sheath.
- Patient education and follow-up: Ongoing monitoring and patient education help ensure a full recovery.
Early diagnosis and treatment are key to reducing pain and preventing long-term complications.
