De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis, often simply referred to as De Quervain’s syndrome, is a painful condition that affects the tendons on the thumb side of the wrist. Specifically, it involves inflammation and irritation of the tendons that run through a narrow tunnel (tendon sheath) at the base of the thumb. These tendons are responsible for moving the thumb away from the palm and allowing it to move in various directions.

De Quervain’s tenosynovitis is typically caused by repetitive movements or overuse of the thumb and wrist, leading to irritation and swelling of the tendons and their surrounding sheaths. Activities that involve grasping, pinching, or repetitive twisting motions of the wrist can contribute to the development of this condition.

Symptoms of De Quervain’s tenosynovitis include:

• Pain and tenderness at the base of the thumb, especially when gripping, pinching, or twisting objects.
• Swelling and a lump or bump at the site of the tendons.
• Limited range of motion and discomfort when moving the thumb and wrist.
• Pain that may radiate up the forearm.

Diagnosis of De Quervain’s tenosynovitis is usually made based on a physical examination of the affected hand and thumb, as well as a review of the patient’s medical history. Finkelstein’s test is a specific diagnostic maneuver where the patient makes a fist with the thumb inside and then bends the wrist toward the little finger side. If this causes pain at the base of the thumb, it is often indicative of De Quervain’s tenosynovitis.

Treatment for De Quervain’s tenosynovitis may include:

• Rest and Activity Modification: Avoiding activities that exacerbate the pain and giving the affected hand and thumb adequate rest can help reduce inflammation.
• Immobilization: Wearing a thumb splint or brace can help limit movement of the thumb and wrist, allowing the inflamed tendons to heal.
• Ice: Applying ice to the affected area can help alleviate pain and reduce inflammation.
• Anti-inflammatory Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce swelling.
• Corticosteroid Injections: In some cases, a healthcare provider may recommend a corticosteroid injection into the affected area to reduce inflammation and provide relief.
• Physical Therapy: Stretching and strengthening exercises prescribed by a physical therapist can aid in the recovery process and prevent recurrence.
• Surgery: In cases where conservative treatments do not provide relief, surgical intervention to release the constricted tendon sheath might be considered.

Early intervention and appropriate treatment can lead to successful management of De Quervain’s tenosynovitis and alleviate the associated pain and discomfort. If you suspect you have this condition, consulting a medical professional is recommended for proper diagnosis and treatment recommendations.