De Quervain's Tenosynovitis | Orthopaedics | Loyola Medicine

De Quervain's Tenosynovitis

Overview and Facts about De Quervain's Tenosynovitis

De Quervain's tenosynovitis is a painful condition caused by inflammation of the tendons beneath your thumb. Pain arises when you try to grip something, make a fist or turn your wrist. It is thought to be caused by repetitive hand movements and is usually treatable through therapy or mild medication, although outpatient surgery may be necessary in more severe cases.

Signs and Symptoms of De Quervain's Tenosynovitis

Symptoms of de Quervain's tenosynovitis may include the following:       

  • Pain surrounding the base of your thumb
  • Swelling and redness around the base of your thumb
  • Difficulty moving your wrist when you try to grasp something
  • Stiffness or sticking when you try to move your thumb

Causes and Risk Factors of De Quervain's Tenosynovitis

Although the exact cause of de Quervain's tenosynovitis is unknown, medical experts believe it is due to chronic overuse of the wrist. Repetitive movements day after day can irritate protective sheaths that surround two tendons in your lower thumb and wrist that enable you to grip, pinch and grasp things with your hands. If the irritation is too severe, inflammation and movement restriction can occur. Other causes of this condition include injury to your wrist and rheumatoid arthritis.

Risk factors for de Quervain's tenosynovitis include:

  • Age, with there being a higher risk for this condition between the ages of 20 and 59.
  • Sex, with women being more at risk than men.
  • Pregnancy, due to increased fluid retention in the body during this period.
  • Childcare, with thumb and wrist strain possible from repeatedly lifting a child.
  • Jobs or hobbies, with risk coming from those that require repetitive hand and wrist motions.

Tests and Diagnosis of De Quervain's Tenosynovitis

To diagnose de Quervain's tenosynovitis, your physician will examine the affected hand to see if pressure applied to the thumb side of your wrist causes pain. Your physician will also give you a Finkelstein test. This involves bending your affected thumb across the palm of your hand, bending your fingers down over your thumb and then bending your wrist toward your little finger. If these movements cause pain, you probably have de Quervain's tenosynovitis. Your doctor may then confirm the diagnosis with an X-ray.

Treatment and Care for De Quervain's Tenosynovitis

If treatment is started early, you should see improvement within four to six weeks. Treatment may include:

  • Medication, such as over-the-counter pain relievers like naproxen (Aleve) or ibuprofen (Motrin, Advil). Corticosteroid injections may also be recommended to reduce inflammation.
  • Therapy, such as immobilizing your wrist and thumb with a brace, avoiding repetitive movements and applying ice to your wrist.
  • Surgery, which involves opening the tendon’s sheath so it can glide more easily. You may meet with a physical therapist after surgery to help strengthen your wrist.