The Inflammation Behind De Quervain’s tenosynovitis

Symptoms and diagnosis for De Quervain’s tendinosis
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By Orthopaedic and Neurology Clinic

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What is De Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain’s tenosynovitis, it will probably hurt when you turn your wrist, grasp anything or make a fist.

A sprain or overusing the tendons through repetitive movements of the thumb at work or during sport tend to make the swelling and pain worse.

In addition, this condition may occur in women during pregnancy or after giving birth to their child.

Having to carry and pick up an infant repeatedly who is rapidly gaining weight can cause overuse of the tendons of the wrist near the thumb. It can be very unpleasant, with pain that radiates up and down the forearm.

What are some symptoms of De Quervain’s tenosynovitis?

If you have de Quervain’s, you’ll probably notice:

  • Pain along the back of your thumb, directly over the two tendons.
  • Swelling and pain at the base of your thumb
  • Swelling and pain on the side of your wrist
 

The condition can happen gradually or start suddenly. In either case, the pain may travel into your thumb or up your forearm.

It may be hard and painful to move your thumb, particularly when you try to pinch or grasp things. The pain may get worse when you move your thumb or wrist.

De Quervain’s tenosynovitis can also cause swelling at the wrist and thumb area.  Some individuals develop a fluid-filled cyst in this region.  You may hear crackling noises or feel a catch when you move your thumb.  Some people have difficulty moving their thumb and wrist.

“Chronic overuse of your wrist is commonly associated with de Quervain’s tenosynovitis.”

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What types of diagnosis?

To diagnose de Quervain’s tenosynovitis, our Specialist will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist.

Our doctor will also perform a Finkelstein test, in which you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain’s tenosynovitis.

Imaging tests, such as X-rays, generally aren’t needed to diagnose de Quervain’s tenosynovitis.

Possible treatment methods?

To ease the pain and inflammation when you move your thumb and to stop it from happening again. Possible treatment involves:

Medications. You’ll start with over-the-counter pain relievers to ease the swelling.

If that doesn’t work, our doctor may do injection into the tight covering, or sheath, that surrounds your tendon. If you do this within 6 months after you notice symptoms, you might fully recover with no more treatment.

Splint and physical therapy. Our Specialist will probably order a splint that will hold your thumb and wrist firm and still. You’ll wear it 24 hours a day for 4 to 6 weeks.

You will also receive therapy to teach you exercises to build strength in your wrist, hand, and arm.

Surgery. For de Quervain’s, we often perform a surgical procedure called a release. The goal of a surgical release is to “release” the tendon sheath that wraps around the base of the thumb, relieving pressure and friction and allowing movement.

During the surgical release, we’ll make an incision in the skin on the side of your wrist near the base of your thumb and open the tight band over the swollen part of the tendon. This will allow the tendon to move freely without pain. We’ll then stitch the incision closed.

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