What is de Quervain’s tenosynovitis?

De Quervain’s (pronounced də kâr-vānz') tenosynovitis is a hand condition that causes pain on the base of the hand behind the thumb. The condition occurs when tendons in the base of the thumb become inflamed and swollen.

The inflammation causes pressure on nerves nearby, which leads to pain and numbness.

Causes of de Quervain’s tenosynovitis

The exact cause of de Quervain’s tenosynovitis is unknown, but repetitive motion in the wrist or hand exacerbate the injury.

Risk factors for de Quervain’s tenosynovitis

Women over 40 years old are the most likely demographic group to develop de Quervain’s tenosynovitis.

Other risk factors associated with de Quervain’s tenosynovitis are:

  • Injury – if you have injured your wrist and developed scar tissue around the area, the scar tissue can restrict movement in the tendons.
  • Career – people with careers that involve repetitive hand or wrist movements are at a higher risk for developing de Quervain’s tenosynovitis.
  • Pregnant women – pregnant women are at a higher risk of developing de Quervain’s tenosynovitis due to the hormonal changes that occur during pregnancy.
  • Arthritis

Symptoms of de Quervain’s tenosynovitis

The most common symptoms of de Quervain’s tenosynovitis are pain or swelling near the base of the thumb. The pain typically worsens gradually and can come on periodically.

Other symptoms of de Quervain’s tenosynovitis include:

  • Inability to move the thumb and wrist when doing something involving grasping or pinching
  • Sticking sensation when moving the thumb
  • Numbness between back of thumb and index finger
  • A fluid-filled cyst in the area impacted

Diagnosis of de Quervain’s tenosynovitis

De Quervain’s tenosynovitis is diagnosed under the care of your orthopedic physician or primary care provider.

If the physician suspects the patient has de Quervain’s tenosynovitis, he or she typically will perform a Finkelstein test. The Finkelstein test involves bending the thumb so it rests on the palm, closing the fingers over the thumb and bending the wrist toward the little finger. Pain in the base of the thumb during this procedure typically indicates that the patient has de Quervain’s tenosynovitis.

Treatments for de Quervain’s tenosynovitis

The treatments for de Quervain’s tenosynovitis are intended to reduce pain and swelling in the impacted area.

If the condition is not severe, your physician may recommend starting treatment with rest, anti-inflammatory medication and hot/cold compresses to the affected area.

If the condition does not improve, he or she may prescribe a splint or brace for four to six weeks (24 hours a day).

More advanced treatments for de Quervain's tenosynovitis include:

  • Steroid injection
  • Surgical release

Recovery from de Quervain’s tenosynovitis

After surgery for de Quervain’s tenosynovitis, recovery may involve wearing a split for one to four weeks.

In most cases, patients will resume normal activities without pain within six to 12 weeks.

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