De Quervain's tenosynovitis
De Quervain's tenosynovitis
De Quervain's tenosynovitis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) 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 every time you turn your wrist, grasp anything or make a fist.
Although the exact cause of de Quervain's tenosynovitis isn't known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports or lifting your baby — can make it worse.
Symptoms of de Quervain's tenosynovitis include:
If the condition goes too long without treatment, the pain may spread farther into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.
When to see a doctor
If the pain continues to interfere with your daily life or activities, seek medical advice.
Chronic overuse of your wrist is commonly associated with de Quervain's tenosynovitis.
When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons normally glide unhampered through the small tunnel that connects them to the base of the thumb. If you repeat a particular motion day after day, it may irritate the sheath around the two tendons, causing thickening that restricts the movement of the tendons.
Other causes of de Quervain's tenosynovitis include:
People between the ages of 30 and 50 have a higher risk of developing de Quervain's tenosynovitis than do those in other age groups. The condition is more common in women than in men, and it may be associated with pregnancy. Baby care, which involves using your thumbs as leverage to lift your child hundreds of times a day, may also be associated with the condition.
Jobs or hobbies that involve repetitive hand and wrist motions may contribute to de Quervain's tenosynovitis as well.
If de Quervain's tenosynovitis is left untreated, it may be hard to use your hand and wrist properly. If the affected tendons are no longer able to slide within their tunnel, you may develop a limited range of motion.
Preparing for your appointment
Make an appointment with your doctor if you have hand- or wrist-related pain and self-care measures — such as avoiding activities that trigger your pain — aren't helping. After an initial exam, your doctor may refer you to an orthopedist, rheumatologist, hand therapist or occupational therapist.
Here's some information to help you get ready for your appointment, and know what to expect from your doctor.
What you can do
Below are some basic questions to ask a doctor who evaluates you for wrist- or hand-related symptoms. If any additional questions occur to you during your visit, don't hesitate to ask.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
To diagnose de Quervain's tenosynovitis, your doctor will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist.
Your doctor will also perform a test called the Finkelstein test. In a Finkelstein test, 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.
A test called the Finkelstein test can help your doctor confirm de Quervain's tenosynovitis. To do this test, you bend your thumb down across the palm of your hand, and then cover your thumb with ...
Treatments and drugs
Treatment for de Quervain's tenosynovitis may include medications, physical or occupational therapy, or surgery. Treatment is generally successful if begun early on, though the pain may recur if you can't discontinue the repetitive motions that aggravate your condition. If you start treatment early on, your symptoms of de Quervain's tenosynovitis should generally improve within four to six weeks. When de Quervain's tenosynovitis starts during pregnancy, symptoms usually get better around the end of pregnancy or when breast-feeding stops.
Your doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.
You may also see a physical or occupational therapist. These therapists may review your habits and give suggestions on how to make necessary adjustments to relieve stress on your wrists. Your therapist can also teach you exercises focused on your wrist, hand and arm to strengthen your muscles, reduce pain, and limit the irritation of the tendons. The therapist may also make a splint to keep your wrist and thumb from moving if off-the-shelf versions don't fit you well.
Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.
Lifestyle and home remedies
If you don't need surgery, caring for your condition is much the same as preventing it:
Last Updated: 2012-08-01
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