De Quervain’s Tendinosis
Anatomy of the Hand Tendons
Tendons are strong, flexible bands of tissue that connect the muscles of your hands to the bones, allowing movement. Each tendon is surrounded by a thin, protective layer known as the synovial sheath, which helps reduce friction during movement.
On the thumb side of the wrist, the extensor pollicis brevis and abductor pollicis longus tendons help with the movement of the thumb.
What is De Quervain’s Tendinosis?
The exact cause of De Quervain’s tenosynovitis is not fully understood. However, it commonly develops due to repetitive hand or wrist movements, direct injury to the wrist or tendons, or underlying inflammatory conditions such as rheumatoid arthritis and inflammatory arthritis.
This condition occurs frequently in pregnant women and individuals in middle age, particularly women.
Early Symptoms of De Quervain’s Tendinosis
De Quervain’s tenosynovitis commonly causes pain and tenderness along the thumb side of the wrist, near the base of the thumb. Mild swelling and redness may also appear in this area. Symptoms often worsen while making a fist, gripping or holding objects, or rotating the wrist.
Some people may notice a catching, popping, or snapping sensation when moving the thumb.
Diagnosis of De Quervain’s Tendinosis
Doctors diagnose De Quervain’s tenosynovitis by reviewing your symptoms, medical history, and performing a physical examination of the wrist. This condition is commonly confirmed using the Finkelstein test.
During this test, you are asked to make a fist with your thumb tucked inside your fingers and then bend the wrist toward the little finger. Sharp pain during this movement indicates De Quervain’s tenosynovitis.
Treatment for De Quervain’s Tendinosis
Treatment for De Quervain’s tendinosis includes both surgical and non-surgical options, depending on symptom severity.
Non-surgical treatment focuses on reducing pain and inflammation. This may involve avoiding activities that worsen symptoms, applying ice to the affected area, wearing a splint to support and rest the wrist and thumb, and participating in physical therapy. Anti-inflammatory medications can help relieve pain and swelling. In some cases, a corticosteroid injection may be recommended to decrease inflammation in the tendon sheath.
Surgery is considered when symptoms persist despite conservative treatment. The procedure is typically performed on an outpatient basis and involves releasing or opening the inflamed portion of the tendon sheath. This reduces pressure on the tendon and allows smoother, pain-free movement of the wrist and thumb.
Post-Operative Care After Surgery for De Quervain’s Tendinosis
Following surgery, a wrist splint is typically worn for about a month to allow the thumb and fingers to remain free and mobile. Your surgeon will also guide you through specific exercises to help strengthen the thumb and restore normal movement.
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