What’s de Quervain's Tenosynovitis?

De Quervain's tenosynovitis (also called de Quervain’s disease or de Quervain’s syndrome) is a painful inflammation of tendons in the thumb that extend to the wrist. The swollen tendons rub against the narrow tunnel they pass through. That causes pain at the base of the thumb and into the lower arm.

Causes

Doctors often don’t know why someone has de Quervain's tenosynovitis. It can happen because of overuse, a direct blow to the thumb, repetitive grasping, and certain inflammatory conditions such as rheumatoid arthritis. Gardening, racquet sports, and some workplace tasks can make it worse.

Who Gets It?

Although anyone can get de Quervain's tenosynovitis, it affects women eight to 10 times more often than men. It may happen in the time just after pregnancy.

Symptoms

Pain along the back of the thumb, directly over two thumb tendons, is common in de Quervain's.

The condition can happen gradually or start suddenly. In either case, the pain may travel into the thumb or up the forearm.

It may be hard and painful to move your thumb, particularly when pinching or grasping things. Some people also have swelling and pain on the side of the wrist at the base of the thumb. The pain may get worse when you move your thumb or wrist.

de Quervains Arthritis

Diagnosis

You’ll probably get the “Finkelstein test.” Your doctor will ask you to make a fist with your thumb placed in your palm. When the wrist is bent toward the little finger, the swollen tendons are pulled through the tight space and stretched. If this movement is painful, you may have de Quervain's tenosynovitis.

Treatment

Your doctor will likely recommend that you wear a splint 24 hours a day for 4 to 6 weeks to hold the thumb and wrist firm and still. You'll also need to stop doing anything that worsens the condition.

You can ice the area to reduce inflammation. If your symptoms continue, your doctor may give you anti-inflammatory medication such as naproxen or ibuprofen, or he may inject the area with steroids to curb pain and swelling.

If these treatments don’t help, your doctor may recommend surgery. The operation would release the tendon’s tight covering, called the “tendon sheath,” so that the tendon can move smoothly. It’s an outpatient procedure, which means you go home afterward. Your doctor will recommend an exercise program to strengthen your thumb and wrist.

Recovery times vary depending on your age, general health, and how long you’ve had the symptoms.

If your de Quervain's disease has developed gradually, it's often tougher to treat. So it may take you longer to get relief.

WebMD Medical Reference Reviewed by Nayana Ambardekar, MD on November 11, 2017

Sources

SOURCE:
American Academy of Orthopaedic Surgeons.

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