DeQuervain’s tenosynovitis

DeQuervain’s tenosynovitis

Hand and Wrist ​Condition

DeQuervain’s tenosynovitis

De Quervain’s tenosynovitis occurs when the tendons around the base of the thumb are irritated or constricted. This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist.

Anatomy

Two of the main tendons to the thumb pass through a tunnel (or series of pulleys) located on the thumb side of the wrist. Tendons are covered by a slippery thin soft-tissue layer, called synovium. This layer allows the tendons to slide easily through a fibrous tunnel called a sheath.

Any swelling of the tendons and/or thickening of the sheath, results in increased friction and pain with certain thumb and wrist movements.

Causes

De Quervain’s tendinosis may be caused by overuse. It also is associated with pregnancy and rheumatoid disease. It is most common in middle-aged women.

Symptoms

Signs of De Quervain’s tendinosis:

Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use.

Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid-filled cyst in this region.

A “catching” or “snapping” sensation may be felt when moving the thumb.

Treatment

The goal in treating de Quervain’s tendinosis is to relieve the pain caused by irritation and swelling.

Non-surgical treatment
  • Splints.
  • Anti-inflammatory medication (NSAIDs).
  • Avoiding activities that cause pain and swelling.
  • Corticosteroids.
Surgical treatment

Surgery may be recommended if symptoms are severe or do not improve. The goal of surgery is to open the thumb compartment (covering) to make more room for the irritated tendons.

Regardless of the treatment, normal use of the hand usually can be resumed once comfort and strength have returned. Your orthopaedic surgeon can advise you on the best treatment for your situation.