De Quervain's Tenosynovitis

Overview

De Quervain’s tenosynovitis is a painful orthopedic condition that affects the wrist on the side of your thumb. Patients who suffer from de Quervain’s tenosynovitis, experience pain when they grasp an object or turn your wrist.

While the exact cause of de Quervain's tenosynovitis is not known, activities that require repetitive hand movements can intensify your symptoms.

De Quervain’s tenosynovitis causes

De Quervain’s tenosynovitis develops from chronic overuse of the wrist. Examples of repetitive movements that may cause de Quervain’s tenosynovitis include:

• Repetitive hand/wrist movements from an assembly line job.
• Moving a child in and out of a car seat.
• Lifting heavy bags with handles.
• Playing golf or tennis.

Other causes of de Quervain's tenosynovitis include:

• Direct wrist injury.
• Inflammatory arthritis.

De Quervain’s tenosynovitis symptoms

The most common symptoms of de Quervain’s tenosynovitis are pain and swelling at the base of your thumb.

Other common symptoms of de Quervain’s tenosynovitis include:

• Trouble moving the thumb or wrist when performing an activity that requires grasping or pinching.
• A sticking feeling when you move your thumb.

De Quervain’s tenosynovitis complications

If left untreated, de Quervain’s tenosynovitis can progress deeper into the thumb, or into your forearm. Any type of grasping or pinching motion can worsen the pain.

De Quervain’s tenosynovitis risk factors

Although anyone can develop de Quervain’s tenosynovitis, some factors increase a person’s risk of developing it. Risk factors include:

• Females are more likely to develop de Quervain’s tenosynovitis.
• People over 40 are more likely to develop de Quervain’s tenosynovitis.
• Occupations or sports. Performing jobs or participating in activities that require repetitive wrist or hand movements.
• Previous wrist injury.
• Having rheumatoid arthritis.
• Being pregnant.

De Quervain’s tenosynovitis prevention

To prevent de Quervain's tenosynovitis, avoid repetitive wrist movements, or change your activities to reduce the strain on your wrists. You can also wear a splint on your thumb or wrist to keep it still during healing.

De Quervain’s tenosynovitis diagnosis

Your doctor can diagnose de Quervain's tenosynovitis. During a clinic visit, your doctor will perform a physical exam where he or she will examine your hand.

If your doctor suspects you have de Quervain’s syndrome, he or she may perform a Finkelstein test. During a Finkelstein test, your doctor will bend your thumb across the palm of your hand while also bending your fingers down to the thumb and then bending your wrist toward the little finger.

Typically, imaging tests are not needed to diagnose de Quervain’s tenosynovitis.

De Quervain’s tenosynovitis treatment

The goal of treatment for de Quervain’s tenosynovitis is to relieve pain and swelling. Your doctor will develop a treatment plan for your case. Treatment options include:

• Apply ice or heat to the affected wrist.
• Take medications such as nonsteroidal anti-inflammatory drugs.
• Avoid activities or repetitive movements that cause symptoms.
• Wear a splint to stabilize the area.
• Get a steroid injection directly into the tendon.
• Start physical therapy to learn new movements and learn exercises to reduce stress on the wrist.

If conservative treatments are not effective in treating your condition, you may need surgery. During the surgery, your doctor will cut the sheath around the swollen tendons to allow the tendons to move more freely. You will likely need physical therapy after surgery to regain strength in the wrist or thumb.

When to Seek Care

Schedule an appointment with your doctor if your symptoms are not improving with conservative care such as ice, heat, or over-the-counter medications.

Next Steps

In preparation for your doctor's visit, take notes about your symptoms, when they started, what causes them to intensify, and where they are most severe.

Once diagnosed, carefully follow your doctor’s instructions to ensure the quickest recovery.

If treated appropriately, de Quervain’s tenosynovitis is a short-term condition. Once symptoms have improved, follow your doctor’s instructions on how to modify your activities to prevent a recurrence. 

If your symptoms worsen or you lose mobility or feeling in your hand or wrists, call your doctor right away for the next steps.