De Quervain’s Tendinitis is a medical condition that affects the tendons located at the base of the thumb. There are two main tendons in the thumb which pass through a tunnel kind of an enclosure referred to as the sheath. A thin layer of slippery tissue, called synovium, covers the tendons and facilitates their passage through the sheath. Irritation or constriction may cause these tendons to swell and rub against the outer sheath. The condition mainly affects women between the age of 35 and 50 years.
Causes
- Prolonged repetitive movement of the hand and wrist joint while playing golf, gardening, playing badminton or tennis etc.
- Overuse injuries to the thumb or wrist joint
- Pregnancy may cause certain internal changes resulting in inflammation of the tendons
- Rheumatoid Arthritis in the hand or wrist joint
- Lifting a baby may stress the hand over a period of time
- Past injuries may result in the formation of a scar tissue which may hamper the movement of the tendons at the base of the thumb
Symptoms
- Difficulty or pain while grasping, clenching a fist, holding or lifting weights, pinching or wringing clothes
- Pain may be sudden or set in gradually. It may be initially felt in the thumb or wrist and radiate upwards to the forearm
- The base of the thumb may be swollen and tender to touch
- The patient may feel a snapping kind of sensation when the thumb is moved or used
Diagnosis
- Finkelstein Test – This is a physical test in which the patient is asked to make a fist and then bend the wrist in the direction of the little finger. If pain is felt while performing this test, it confirms the presence of De Quervain’s Tendinitis
- The doctor may palpate and apply pressure at the base of the thumb to check if it causes pain
- X-ray imaging may be required to assess the bone structure and detect a fracture or dislocation
- The patient may be inquired about his daily activities, sports played and previous wrist injuries, if any
Treatment
De Quervain’s Tendinitis can be treated both surgically as well as non-surgically depending on the underlying cause and the severity of the condition. The methods adopted may include the following:
- A soft removable splint or a brace may be worn to hold the thumb and wrist in place as well as give them rest for a few weeks
- Anti-inflammatory medicines may be prescribed to provide relief from the symptoms
- Activities that involve excessive use of the hand need to be avoided. This can be helpful in easing the pain and swelling
- Corticosteroid injections may be administered directly at the point of inflammation to provide immediate relief
- Application of ice packs at regular intervals can be effective
- Surgery can be performed to expand the thumb compartment in order to create space for the swollen tendons
- Physical therapy may be recommended to reinstate the stability and functionality of the thumb.
- Specific exercises may be designed to strengthen the supporting muscles and reduce pain
- Occupational therapists may advise the patient on proper usage of the hand without irritating the tendons
Visit OrthoTexas for complete treatment of De Quervain’s Tendinitis. To schedule an appointment with the wrist specialists, call 972-492-1334 (678.4689).