What is de Quervain's tenosynovitis?
Quervain's (say "duh-kair-VANZ") tenosynovitis, also called De Quervain's, is a problem that makes the bottom of
your thumb and the side of your wrist hurt. When you have
de Quervain's, the ropey fiber (tendon) that helps move your thumb away from your
fingers becomes swollen. See a picture of
de Quervain's .
What causes de Quervain's?
People can get de Quervain's when they
hurt or use the thumb or wrist too much. Common activities that need your wrist
and thumb can cause the problem. Some activities that might cause de Quervain's
- Wringing out wet
heavy objects such as a jug of milk, taking a frying pan off of the stove, or
lifting a baby out of a crib.
If you are pregnant or if you have
rheumatoid arthritis, you are more likely to get de
Quervain's. More women than men have de Quervain's. You can get
the disease at any age. Most people who have de Quervain's are women
between the ages of 30 and 50.
What are the symptoms?
De Quervain's may cause pain when you
twist your wrist. You might also have pain if you grab something between your
thumb and finger. Many people hear a funny sound like a squeak, crackle, snap,
or creak when they move the wrist or thumb.
The bottom of the
thumb or the side of the wrist might also be sore or swollen. This can make it
hard to move your thumb or wrist. The back of the thumb and index finger may
also feel numb. Sometimes de Quervain's can cause a
small bump on the thumb side of the wrist. If you don't get
treatment, the pain can spread up your forearm or down into your thumb.
How is de Quervain's diagnosed?
Your doctor will check for swelling, tenderness, or numbness around the base of the thumb. There may also be crackling or popping when you move your thumb.
doctor may or may not use the Finkelstein test to help diagnose de Quervain's. To do this test, make a fist with your thumb inside. Then bend your
wrist outward toward your little finger. If you feel pain on the thumb side of
your wrist, then you most likely have de Quervain's.
Finkelstein test is done to make sure that you do not have a different problem,
such as arthritis in the bottom of your thumb or
intersection syndrome. Both of these problems affect
the same area of the hand and wrist as de Quervain's.
How is it treated?
The goal of treatment for
de Quervain's is to relieve the pain and swelling in your thumb and
wrist, and restore normal function. Try the following steps to help your
- Avoid moving the hand and wrist that hurt.
- Until your symptoms are
the activities that caused the pain.
- Keep your wrist in a straight line with your arm by using a
splint to keep your thumb and wrist from moving.
Try ice or heat on the area that hurts or is swollen. You can use ice
for 15 minutes every 4 to 6 hours. Put a thin cloth between the ice and your
skin. You can use heat for 20 to 30 minutes, 2 or 3 times a day. Try using a
heating pad, hot shower, or hot pack.
nonsteroidal anti-inflammatory drugs (NSAIDs),
including ibuprofen (such as Advil) or naproxen
(such as Aleve). NSAIDs come in pills and in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain.