DE QUERVAIN’S TENOSYNOVITIS

A painful condition of the wrist, De Quervain’s tenosynovitis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) affects the tendons on the thumb side of your wrist. If you have de Quervain’s tenosynovitis, the wrist will hurt when you rotate it, grasp objects or make a fist.

Although physicians do not know the exact cause of De Quervain’s Tenosynovitis, any activity that applies repetitive movement to the hand or wrist — such as yard work, golf, racket sports, or lifting children — can make it worse.

Symptoms

Symptoms of De Quervain’s Tenosynovitis can include:

  • Pain and swelling at base of your thumb
  • Difficulty grasping or pinching objects using the thumb
  • A “sticking” sensation in your thumb when attempting to move it

If patients allow the condition to advance without treatment, the pain may spread further into the forearm. Pinching and grasping movements aggravate the pain.

Conservative Treatment

  • Avoid using the affected thumb 
  • Apply cold to the pain
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen

Causes

Physicians determine Chronic overuse of the wrist as the most common cause of De Quervain’s tenosynovitis.

When you grip, grasp, clench, pinch or wring anything in your hand, the tendons in your wrist and lower thumb normally glide smoothly through the small tunnel that connects to the base of the thumb. Repetitively making the same motion on a daily basis can irritate the sheath around the wrist tendons, which causes them to thicken and swell, which restricts their movement.

Other possible causes of De Quervain’s Tenosynovitis can include:

Risk factors

If you line up with any of the following, you could have a higher risk of presenting with De Quervain’s Tenosynovitis: 

  • Age. Those between the ages of 30 and 50, have a higher risk of developing de Quervain’s tenosynovitis than other age groups.
  • Sex. De Quervain’s Tenosynovitis more commonly appears in women.
  • Pregnancy. De Quervain’s Tenosynovitis often appears alongside pregnancy.
  • Baby care. Repeatedly lifting a baby involves putting leverage on the thumbs which can lead to the condition.
  • Any Job or hobby that involves repetitive hand motions. These may also contribute to de Quervain’s tenosynovitis.

De Quervain’s Release Surgery 

Hand and Wrist Specialists can perform a “De Quervain’s release”, an outpatient procedure to relieve the symptoms of De Quervain’s tenosynovitis. This procedure releases the sheath of the tendon that wraps around the base of the thumb, which relieves pressure and friction. De Quervain’s release surgery allows the tendons to glide freely once again when moving the thumb and wrist.

During a De Quervain’s Release surgery, the hand surgeon makes a small incision near the base of the thumb on the wrist. The surgeon then locates the inflamed tendon and makes a small slit in the sheath surrounding the tendon, releasing it. This allows the tendon sheath to open wider and relieves pain by releasing pressure and friction within the tendon.

After the surgery, the hand surgeon will close the incision with sutures, bandages, and then apply a splint. As an outpatient procedure, Patients will go home from the hospital the same day as the operation.