What Is de Quervain's Tenosynovitis?
De Quervain's tenosynovitis is inflammation around the tendons in your thumb that leads to painful swelling. It's also called de Quervain's tendinosis or de Quervain's tendinitis. Repetitive movements of your thumb or wrist cause the swelling.
When the swollen tendons rub against the narrow tunnel they pass through, it causes pain at the base of your thumb and into your lower arm.
De Quervain's Tenosynovitis Causes
Doctors often don’t know why you get de Quervain's tenosynovitis. But it does result from:
- A direct blow to the thumb
- Inflammatory conditions like rheumatoid arthritis
- Overuse in hobbies
- Repetitive workplace tasks
De Quervain's Tenosynovitis Risk Factors
If you use your thumbs or wrists a lot in any kind of activity, that raises the chances you'll get de Quervain's tenosynovitis. Among the things that can put you at risk are:
- Parenting young children
- Working with young children
- Sports, especially skiing, golf, rowing, and racket sports such as tennis
- Manual labor, such as swinging a hammer repeatedly
- Hobbies such as knitting, gardening, or gaming
- Using smartphones or tablets
Who Gets de Quervain's Tenosynovitis?
Anyone can get de Quervain's tenosynovitis, and it's one of the most common forms of tenosynovitis. Experts think about 1% of people in the U.S. are affected by it each year.
Certain demographic factors put you at higher risk:
- Age: Adults between 30 and 50 are most likely to get it.
- Gender: Women and those assigned female at birth are 8 to 10 times more likely to get it.
- Pregnancy: Changes in your body may make it more likely.
- Giving birth: It often happens just after pregnancy. Lifting your baby repeatedly might bring it on.
De Quervain's Tenosynovitis Symptoms
If you have de Quervain’s, you’ll probably notice:
- Pain along the back of your thumb, directly over the two tendons
- Swelling and pain at the base of your thumb
- Swelling and pain on the side of your wrist
- A sensation that your thumb is sticking when you try to move it
- Numbness
- Popping sensation in your wrist
- A fluid-filled sac, called a cyst, on the thumb side of your wrist
The condition can happen gradually or start suddenly. In either case, the pain may travel into your thumb or up your forearm.
It may be hard and painful to move your thumb, particularly when you try to pinch or grasp things. The pain may get worse when you move your thumb or wrist.
De Quervain's Tenosynovitis Diagnosis
Your doctor will check your hand to see if it hurts when pressure is applied to the thumb side of your wrist.
Next, you’ll get the Finkelstein test. The doctor will ask you to bend your thumb across your palm. Then you’ll bend your fingers down over your thumb to make a fist. This movement stretches your tendons. If it hurts on the thumb side of your wrist, you probably have de Quervain's tenosynovitis.
You might get X-rays or other imaging tests to check for an underlying problem like osteoarthritis.
De Quervain's Tenosynovitis Treatment
The goal of treatment is to ease the pain and inflammation when you move your thumb and to stop it from happening again. It involves:
Medications. You’ll start with over-the-counter pain relievers like ibuprofen or naproxen to ease the swelling.
If that doesn’t work, your doctor may inject steroids into the tight covering, or sheath, that surrounds your tendon. If you do this within 6 months after you notice symptoms, you might fully recover with no more treatment.
Splint and physical therapy. Your doctor will probably order a splint that will hold your thumb and wrist firm and still. You’ll wear it 24 hours a day for 4 to 6 weeks.
You will also receive therapy to teach you exercises to build strength in your wrist, hand, and arm.
Surgery. If these treatments don’t help, your doctor may recommend surgery. The operation releases the tendon sheath so your tendon can move smoothly.
It’s an outpatient procedure, which means you go home just afterward. You'll probably see a physical therapist again for post-surgery exercises to strengthen your thumb and wrist.
Home remedies and lifestyle changes. See your doctor if you think you have de Quervain’s. But try these methods at home to feel better and keep your thumb healthy:
- Ice the area to ease inflammation.
- Stop doing anything that makes it worse. Avoid repeated motions and pinching moves with your fingers and thumb.
- Wear the splint as long as your doctor tells you to.
- Keep doing your exercises.
How long does it take to recover from de Quervain's tenosynovitis?
The sooner you start treatment, the better your chances for a speedy recovery. You might start to feel better as soon as 4 to 6 weeks.
If your condition is related to pregnancy, you may not feel better until after you give birth or when you stop breastfeeding.
Recovery from surgery could take a while. Your pain and swelling should go away soon, but the area may be tender for several months. You should get your stitches out in 10 to 14 days. Then you’ll start physical therapy again for 6 to 8 weeks. You’ll learn stretches to help your tendons move properly and exercises to strengthen your muscles and keep your joints steady.
De Quervain's Tenosynovitis Prevention
The best way to prevent de Quervain's tenosynovitis is to avoid overuse of your thumb and wrist. Other steps you can take include:
- Make sure you wear protective gear when needed and use the right technique for sports, hobbies, and work.
- Go slow when you're starting a new activity.
- Build in breaks when you're doing something repetitive.
- If your wrist or thumb starts to hurt, stop what you're doing and rest it.
- After a period of intense activity, give your body time to rest.
- Use a heating pad to warm your wrist before activity, and massage your wrist and thumb to loosen them up.
De Quervain's tenosynovitis exercises
You can use a tennis ball to help with strength and flexibility in your thumb and wrist.
- Hold a tennis ball in your affected hand.
- Squeeze it, slowly adding more pressure as long as you're not feeling pain.
- Hold 5 seconds, then release.
- Do 5-10 repetitions a few times each day.
You can also try thumb lifts.
- Put your hand on a flat surface. Your hand should be positioned almost like you're shaking hands, with your pinkie side down, but your thumb should be across your palm.
- Slowly raise your thumb straight up.
- Hold it there for 6 seconds.
- Do 8 to 12 repetitions.
Takeaways
When you have de Quervain's tenosynovitis, you develop painful inflammation around the tendons in your thumb. The most common cause is repetitive activities that overwork those tendons. Rest, medication, and using a splint can help you recover. In rare cases, you might need surgery.
De Quervain's Tenosynovitis FAQs
What is the fastest way to cure de Quervain's tenosynovitis?
If you think you have de Quervain's tenosynovitis, see your doctor for an official diagnosis. Then follow the treatment plan.
What is the best treatment for de Quervain's tenosynovitis?
Your treatment plan will probably include anti-inflammatory medicine, rest, and wearing a de Quervain's tenosynovitis splint at night and all day.
Does de Quervain's ever go away?
Most people improve within a month or so. If your symptoms don't get better, your doctor might recommend surgery.
Is de Quervain's syndrome the same as carpal tunnel?
Although both affect the same area of your body, they aren't the same condition. Carpal tunnel involves a nerve, not tendons. The median nerve, which is on the palm side of your hand, is squeezed when you have carpal tunnel. You can have both carpal tunnel and de Quervain's in the same hand at the same time.
