What Is De Quervain’s Tenosynivitis?
Two of the thumb's main tendons pass through a tunnel on the side of the wrist. They are covered by the synovium, a thin soft-tissue layer which forms a sheath. When the tendons swell or the sheath thickens, it causes friction and pain. It may be especially noticeable when you form a fist, grip an object, or perform repetitive motions.
De Quervain's tenosynovitis can result from strain, continual overuse or injury. It often occurs during pregnancy due to hormone fluctuation and fluid retention. Diabetes, rheumatoid arthritis or infection may also be related to De Quervain’s symptoms. It is most common in women ages 45–65.
What are the symptoms of De Quervain’s tenosynovitis?
De Quervain’s tenosynovitis may cause:
- A grating or catching feeling.
- Pain in the tendon when moving the wrist or thumb.
- Pain that travels up the forearm.
- Swelling from fluid and inflammation.
Pain may be acute (happen suddenly) or chronic – develop slowly and remain constant over time.
How is De Quervain's tenosynovitis diagnosed?
Your doctor will review your health history and give you a physical exam. To make sure no other conditions are causing your symptoms, you may have tests that may include:
- Finkelstein test – You’ll be asked to make a fist with your fingers closed over your thumb, then bend your wrist toward your little finger. If you have De Quervain's tendinosis, this motion is quite painful.
- Joint aspiration – Your doctor takes fluid from your thumb joint and tests for signs of gout or infection.
- X-ray – Although tendons don't appear on X-ray images, your doctor can check the bones for arthritis.
De Quervain's tenosynovitis treatment
Depending on your condition, Franciscan Health specialists can offer a variety of treatment options. Nonsurgical treatment to reduce pain and swelling may include:
- Taking anti-inflammatory medication (NSAIDs).
- Avoiding activities and repetitive motion to allow the symptoms to subside.
- Icing the thumb and wrist.
- Wearing a splint to limit movement of the thumb and wrist.
De Quervain's tenosynovitis injection
Your doctor may recommend corticosteroid injections if initial treatments do not work. Injections typically provide relief within a few days and can last for several weeks.
De Quervain's tenosynovitis surgery
If nonsurgical treatments don't relieve your symptoms, you may require surgery. The expert hand surgeons at Franciscan Health will open the tendon sheath to make more room for the inflamed tendons.
After surgery, you may wear a splint on your hand for one to four weeks and have hand therapy. Complete recovery takes six to 12 weeks.