De Quervain’s Tenosynovitis
Diagnosis and Treatment
Dr. Pamela Mehta, MD
Orthopedic Surgeon, San Jose
Table of Contents
What is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis is a common wrist condition caused by irritated tendons in your wrist.
It often occurs without a clear cause, though factors such as age and sex can put you at a higher risk of developing it. It can be treated with simple measures such as a splint but sometimes requires hand surgery.
This condition is also sometimes known as de Quervain’s tendonitis. It affects two tendons that pass through a tendon sheath in your wrist at the base of your thumb.
These tendons are surrounded by a slippery layer called the synovium, to protect them from friction. When this becomes swollen and inflamed, it causes pain at the side of your wrist.
You can also suffer difficulty with wrist movements.
The cause of de Quervain’s tenosynovitis is often unclear. It is sometimes associated with overuse and repetitive wrist movements. Examples of this include gardening, gaming, or playing tennis.
You are at higher risk of de Quervain’s tenosynovitis if you are:
- Aged 30-50, though those in other age groups can still develop de Quervain’s tenosynovitis
- Female – women are up to 10 times more likely to develop it
- Recovering from, or previously had, a wrist injury
- Pregnant, or have just given birth
- Suffering from rheumatoid arthritis
If you have pain or swelling in your wrist and thumb, you might have de Quervain’s tenosynovitis. Pain can come on suddenly or gradually over time. It is felt at the base of your thumb and outside of your wrist – where the inflamed tendons are found.
Symptoms of de Quervain’s tenosynovitis include:
- Pain at the base of your thumb and outer wrist
- Radiating pain that goes up your forearm or into your thumb
- Swelling near the base of your thumb
- Numbness in your thumb and index finger
- Squeaking sounds or a catching sensation when moving your thumb
Treatment for de Quervain’s tenosynovitis usually conservative (simple) treatments. The aim of treatment is to reduce inflammation and irritation of your tendon sheath.
Simple measures to help with the pain and swelling include:
- Resting your thumb
- Avoiding painful movements
- Taking anti-inflammatory medications
- Placing an ice pack on your wrist
- Gently massaging your wrist
Splints, Braces, and Physical Therapy
Splints can often be bought from a pharmacy, though it’s important that you get a splint that fits well.
Sometimes special exercises can help you recover from de Quervain’s tenosynovitis. It is important that this is supervised by a physical therapist to avoid making things worse.
Dr. Mehta can advise you on whether stretching or exercises will help or harm your symptoms.
Normally, symptoms improve after 4-6 weeks with treatment. If your symptoms are more severe, or aren’t improving with a brace or splint, Dr. Mehta might recommend a cortisone injection.
Cortisone, a type of steroid, is injected into the tendon sheath which is irritated, reducing inflammation and swelling. This relieves the pain in over half of cases.
If your symptoms continue, you may require hand surgery. This is known as de Quervain’s tenosynovitis release or decompression. The procedure opens the tendon sheath in your wrist to make room for the irritated tendons. This can generally be done under a local anesthetic.
Recovery from surgery is usually quick, with pain from your irritated tendons subsiding within the first few days. Physical therapy is often used to help in your recovery from surgery.
You will have a small scar on your wrist which might remain sore for a few weeks after the operation.
What Hand & Wrist Services Do We Offer?
Treatment of Hand & Wrist Conditions
Dr. Mehta offers diagnosis and treatment of all hand & wrist conditions and can offer her specialist opinion as an expert hand doctor.