De Quervain's tenosynovitis is an inflammation of the sheaths of the tendons (tenosynovium) that move the thumb away from the hand. It is technically referred to as a stenosing
tenosynovitis. Both the tendons and their surrounding tissue sheaths are involved in the area where the tendon has to go through a small tunnel of bony and fibrous tissue at the wrist. The inflamed tenosynovium becomes painful at the tunnel area.
De Quervain's Tenosynovitis
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De Quervain’s is a mechanical problem caused by repetitive use of the thumb and wrists. A direct blow to the area may also cause the condition.
De Quervain's tenosynovitis is more common in women. Other factors that may increase your chance of getting de Quervain's tenosynovitis include: Knitting and needlepointLifting a baby or young child oftenBowling or wrestling
Symptoms may include: Pain or tenderness at the base of the thumbPain when pinchingSwelling over the thumb side of the wristA snapping or catching sensation when moving the thumbNumbness on the back of the thumb, spreading to the index finger
You will be asked about your symptoms and medical history. A physical exam will be done.
The Finkelstein test
is often done to help make the diagnosis. Make a fist with your thumb inside your fingers and bend your wrist toward your little finger. If this causes pain at the wrist below your thumb, you may have de Quervain's tenosynovitis.
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Nonsurgical methods to help relieve pain include: Resting the thumb and wristUsing an ice pack for 15-20 minutes at a time—place a towel between the ice pack and your skinAvoiding activity that causes the painUsing a thumb splint to reduce pain and swelling to allow the wrist to restTaking nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen.
An injection of a cortisone-like drug into the tendon sheath is often effective in curing the condition.
If other methods do not help, an orthopedic surgeon will open up the small tunnel of bony and fibrous tissue and possibly remove some of the tendon sheath. This will allow more freedom of movement for the tendons.
Follow these steps to help reduce your chances of getting de Quervain's: Minimize
repetitive thumb activity, or twisting and gripping activitiesReduce stress on you hands through ergonomic practices at work
Best treatment for de Quervain's tenosynovitis uncertain.
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http://www.merckmanuals.com/professional/musculoskeletal_and_connective_tissue_disorders/hand_disorders/de_quervain_syndrome.html. Updated March 2013. Accessed February 28, 2014.
de Quervian tendinitis (de Quervian tendinosis). American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00007. Updated December 2013. Accessed February 28, 2014.
de Quervain tenosynovitis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated July 10, 2013. Accessed February 28, 2014.
Johnson CA. Occurrence of de Quervain's disease in postpartum women—pain and tenderness in wrist.
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Last reviewed February 2014 by Teresa Briedwell, PT, DPT
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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