What is De Quervain’s tenosynovitis?
De Quervain’s disease is a painful wrist condition that affects the tendons on the thumb side of the wrist (the radial side). Symptoms may include pain, or tenderness when moving the thumb, rotating the wrist, gripping something, or forming a fist. Pain may spread to the thumb or forearm. Some people have swelling on the radial side of the wrist, or difficulty holding objects.
Other names for this syndrome include: De Quervains tenosynovitis, De Quervain’s syndrome, De Quervain’s tendonitis or wrist tendonitis.
What causes De Quervain’s tenosynovitis?
Overuse of the wrist and hand is one of the principal culprits. Two main tendons — the extensor pollicis brevis and abductor pollicis longus tendons attach the thumb to the forearm, reaching through the fibrous sheath at the wrist.
What are the symptoms of De Quervain’s tenosynovitis?
The chief symptom of De Quervain’s tenosynovitis is pain at the base of the thumb, oftentimes spreading up to the forearm, particularly during movements — for instance, grasping — that use the thumb and wrist. There may also be swelling adjacent to the thumb side of the wrist, and sometimes a fluid-filled cyst. Even uncomplicated activities, such as picking up a coffee mug, or peeling vegetables may become untenable. Ask your orthopedic wrist doctor in Raleigh, or other locations, to get an accurate diagnosis.
The main symptom of De Quervain’s tenosynovitis is a history of locking, or snapping when bending, or extending the affected finger, or thumb. X-rays are not necessary. Your physician will check for pain and swelling at the base of the finger, or thumb as you open and close your hand and perform other hand movements. Another disease, Dupuytren’s contracture, can also cause difficulty straightening a finger, but it’s usually painless.
The treatment of De Quervain’s tenosynovitis
The first step in treating De Quervain’s tenosynovitis is to stop doing anything that aggravates the condition. The second step is to immobilize the affected finger, or thumb, either by taping it to an adjacent finger, or by using a splint (see the photograph). Splinting at night can be especially helpful in preventing the thumb, or finger from becoming locked. For pain, apply an ice pack several times a day and take an NSAID.
If you still have severe locking or other symptoms after four to six weeks of immobilization, your orthopedic wrist doctor may recommend a steroid injection into the base of the affected finger or thumb. If the trigger finger symptoms still don’t improve after another six weeks, she or he may recommend a second injection. Nonsurgical treatment of trigger finger (and de Quervain’s) is usually effective if administered early on and if you discontinue any repetitive motions that caused, or contributed to the problem in the first place.
Surgery may be advisable when locking and pain persist. During the surgery for this condition, the sheath is opened, which facilitates the tendon to glide through it more easily. This usually restores finger mobility practically immediately, and you can start gentle range-of-motion exercises within a couple of days. Swelling and discomfort may last for a month, or so after the surgery.
Orthopedic Clinic in Raleigh, Cary, Holly Springs and Garner
The Raleigh Orthopaedic Clinic’s, board-certified fellowship trained, hand and upper extremity surgeons bring together many years of experience in diagnosing, managing and correcting various conditions which can literally run from the fingertips to the elbow.
Treatment of the hand, wrist and elbow is a highly specialized field that deals with a plethora of conditions and symptoms. Many of these hand, wrist and elbow conditions are treated with non-surgical approaches, such as medications, injections, and our on-site hand therapy department. However, when hand surgery is indicated, advanced procedures are performed on an outpatient basis and without a hospital stay.
Make an appointment with one of our orthopedic wrist doctors in Raleigh (or our other locations) to get specialized treatment with a personal approach.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.