De Quervain's Tenosynovitis

What is it?

De Quervain’s Tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. 

It is caused by inflammation of two tendons that is involved with thumb and wrist movements. Any activity that relies on repetitive hand or wrist movements – such as working in the garden or racket sports – can make it worse.

What are the symptoms?

Typical symptoms of De Quervain’s Tenosynovitis include:

  • Pain at the base of the thumb
  • Pain that radiates up the wrist and forearm
  • Swelling at the base of the thumb and wrist
  • Tenderness along the thumb, wrist and forearm
  • Pain when doing any activities that relies on pinching or gripping by the thumb
  • Thumb and wrist stiffness

what is the treatment?

The diagnosis of De Quervain’s Tenosynovitis is clinical, meaning that your surgeon can diagnose the condition from the clinic appointment alone. Occasionally an ultrasound scan or X-ray may be needed to rule out other causes of pain.

Treatment of De Quervain’s Tenosynovitis involves splinting and rest in the initial stage. This can be supplemented with simple oral painkillers such as ibuprofen. Specialist hand physiotherapy is also useful for stretching, strengthening of the thumb muscles and pain relief.

A steroid injection can be helpful in relieving pain if symptoms are severe. Quite often this can be used to aid with hand therapy so that the exercises can be completed comfortably.

If all of the above fails, then surgery can be performed. This is aimed at decompressing the two inflamed tendons under tension, so that they can glide more easily and relieve the symptoms.

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