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De Quervain tenosynovitis

Diseases and Conditions De Quervain tenosynovitis
Overview Types Causes & Risk Factors Symptoms Preventions Treatment
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Overview

De Quervain tenosynovitis, also known as dih-kwer-VAIN ten-oh-sine-oh-VIE-tis, is a painful condition that affects the tendons on the thumb side of the wrist. If you’re experiencing symptoms, such as pain when turning your wrist, grasping objects, or making a fist, you might be dealing with this condition.

Types of De Quervain tenosynovitis

De Quervain tenosynovitis typically involves two tendons:

  1. Abductor pollicis longus (APL) tendon: This tendon helps move the thumb away from the palm.
  2. Extensor pollicis brevis (EPB) tendon: Responsible for extending the thumb.

Causes of De Quervain tenosynovitis

The exact cause of De Quervain tenosynovitis remains unclear, but repetitive hand or wrist movements exacerbate the condition. Common activities include:

  • Gardening
  • Playing golf or racket sports
  • Lifting a baby

Risk Factors of De Quervain tenosynovitis

Several risk factors increase the likelihood of developing De Quervain tenosynovitis:

  1. Age: Individuals between 30 and 50 years old are at higher risk.

  2. Gender: The condition is more common in women.

  3. Pregnancy: De Quervain tenosynovitis may be associated with pregnancy.

  4. Baby Care: Repeatedly lifting a child using the thumbs as leverage can contribute to the condition.

  5. Occupational Factors: Jobs or hobbies involving repetitive hand and wrist motions increase the risk.

Symptoms of De Quervain tenosynovitis

Common symptoms of De Quervain tenosynovitis include:
1. Pain near the Base of the Thumb: Individuals with De Quervain tenosynovitis experience localized pain at the base of the thumb, specifically where the thumb meets the wrist. The pain can be sharp, throbbing, or achy. It often worsens with movement, especially when grasping objects or making a fist.
2. Swelling near the Base of the Thumb: Swelling (edema) occurs in the area around the tendons involved. The swelling may be visible or palpable. It contributes to the discomfort and restricts thumb movement.
3. Difficulty Moving the Thumb and Wrist: Individuals find it challenging to perform activities that require thumb and wrist movement. Actions such as pinching, gripping, or turning the wrist may cause pain. The tendons’ restricted gliding motion leads to this limitation.
4. “Sticking” or “Stop-and-Go” Sensation: Some people describe a sensation of the thumb getting stuck or catching during movement. It feels as if the tendon momentarily stops gliding smoothly. This symptom can be bothersome and affect daily tasks.

Preventions of De Quervain tenosynovitis

To prevent or manage De Quervain tenosynovitis:

  • Avoid Repetitive Movements: Minimize repetitive wrist motions.
  • Take Breaks: If your work involves excessive wrist movement, take regular breaks to reduce stress on the tendons.
  • Wear a Brace or Splint: Use a brace or splint during heavy activities involving the wrists.

Diagnosis of De Quervain tenosynovitis

Diagnosing De Quervain tenosynovitis involves a clinical assessment, including the Finkelstein test.

Treatment for De Quervain tenosynovitis

Treatment options include:

  • Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
  • Tendon Release Surgery: In extreme cases, surgery may be necessary to release the tendon sheath and alleviate pressure.
  • Therapy: Massage therapy, physical therapy, and occupational therapy can help restore muscle strength and function.
  • Self-Care: Rest, ice, compression, and elevation (RICE) can reduce swelling and pain.

When to seek medical attention ?

Consult your healthcare provider if you experience persistent pain or functional limitations despite trying conservative measures. Seek medical attention if you’ve already attempted rest, cold application, and NSAIDs.

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