De Quervain’s Syndrome (also known as De Quervain’stenosynovitis/tendinosis/syndrome) is a form of tendinitis that is brought on by irritation or inflammation of the wrist tendons at the base of the thumb. As time goes on these tendons can swell and become enlarged due to this irritation and makes movement of the hand painful.
If symptoms don’t improve or are severe enough, surgery may be needed. The goal of this surgery is to widen the tunnel so that the tendons pass through easily, relieving the pain and irritation. Doctors do this by creating a small incision in the palm and cut the problem tunnel. As the tunnel heals, it widens, allowing for the tendon to pass freely. Once the damage has been repaired, doctors will stitch the incisions closed and bandage the area. Even though the surgery is minimally invasive, it is important to understand all of the risks and to closely follow the doctor’s instructions.
De Quervain Causes
The main reason for the development of De Quervain is from overuse, pregnancy, and rheumatoid arthritis. In most cases, no single cause can be pinpointed, but women are 8-10 times more likely to be affected than men.
De Quervain Diagnosis
Your doctor will put pressure on the thumb side of the wrist to assess whether you feel pain, and perform a Finkelstein test. The test involves you bending your thumb across the palm side of the hand while bending the fingers over the thumb. When you bend your wrist toward your pinky finger, you will feel pain on the thumb side of the wrist if you have De Quervain’s tendinitis. Usually this is the only test needed to diagnose the condition, as imaging tests usually aren’t needed except to rule out other conditions.
Symptoms of De Quervain Syndrome
The main symptom of De Quervain is gradual or sudden pain over the thumb side of the wrist. The pain will either travel down the thumb or up the forearm. Any hand or thumb movement will also increase pain, especially when trying to grab or grasp something. Other symptoms include:
- Swelling over the thumb side of the wrist.
- A catching or snagging sensation when moving the thumb.
- Numbness over the back of the thumb or index finger, caused by the irritation of a nerve lying on top of the tendon sheath.
- Difficulty and pain with thumb motion, which may create a sensation of catching or snapping.
- Pain when pressure is applied to the area.
De Quervain Treatment
Treatment for the condition aims to reduce swelling and the pain and irritation associated with it. Your doctor will start with nonsurgical treatment and progress to surgical treatment for those who don’t respond to conservative measures. Nonsurgical treatment involves the following:
- Splints to immobilize the thumb and wrist to rest the area.
- NSAID drugs to reduce swelling and relive pain associated with the condition.
- Avoid activities which can worsen the pain, which may cause the symptoms to go away on their own.
- Corticosteroids injected into the tendon sheath to help reduce swelling and pain.
- Applying ice to the area which is swollen and painful.
- Avoiding pinching movements or repetitive thumb motions.
If you don’t respond to nonsurgical treatment, outpatient surgery may be recommended to improve you symptoms. Surgical release opens the tendon sheath to open up the area to make more room for the irritated tendons. Once discomfort subsides and strength returns, normal use of the hand can be resumed. Your orthopedic surgeon will help advise you of the best treatment for your condition, which may include physical or occupational therapy.
Like with any surgery, there are risks involved that patients need to be aware of:
- Nerve and blood vessel damage
Is De Quervain Syndrome causing pain and discomfort to your everyday life? Maybe it's finally time to do something about it! Long-lasting relief with minimally invasive procedures are available today! To learn more about De Quervain Syndrome causes, symptoms, and treatment, please contact West Medical at (855) 690-0565, and our helpful medical staff will answer any questions you may have.
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