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Guide to De Quervain’s Tenosynovitis

What is De Quervain’s Tenosynovitis?

De Quervain’s tenosynovitis is an inflammation of the tendons on the thumb side of your wrist. If you have De Quervain’s tenosynovitis you will usually experience pain with grasping, typing or any twisting movements of the wrist.

Some of the symptoms you may experience as a result of de Quervain’s tenosynovitis may include:

  • Pain that may begin abruptly or develop over a couple of weeks.
  • Reduced range of motion of the thumb and wrist as a result of pain
  • Trouble moving your thumb and wrist when trying to grasp or pinch items
  • Pain near the base of the thumb
  • Swelling near the base of the thumb
  • Feeling the thumb is “sticky” and difficult to move

What causes De Quervain’s Tenosynovitis?

The exact cause of this condition is still not yet known, but repetitive movements such as typing, lifting, knitting, cooking or playing musical instruments are some of the known culprits which can make the symptoms worse over time.

How is De Quervain’s Tenosynovitis diagnosed?

The diagnosis of De Quervain’s tenosynovitis will be based on the presenting symptoms and the completion of a complete physical examination which will include orthopaedic and neurological assessment.

A special test called the Finkelstein test will be performed whereby your practitioner will bend your thumb across the palm of your hand and bend your fingers over your thumb. Then you will be asked to bend your wrist towards the pinkie. If this movement causes you pain on the thumb side of the wrist, it will be likely that you may have de Quervain’s tenosynovitis.

How is De Quervain’s Tenosynovitis treated?

The initial treatment will be aimed at reducing the inflammation and preserving whatever movement is left in the thumb. If the treatments are started early on, you should be able to see improvements in symptoms within 4 to 6 weeks.
Some of the initial treatments that you may receive to help with de Quervain’s will be:

  • Splinting your thumb and wrist to ensure that your tendons get some rest.
  • Advice on activity modification such as avoiding repetitive thumb movements and avoiding pinching with the thumb
  • Applying ice to the area

If you find that your condition is extremely painful, another form of treatment would be to have an injection that is performed by our in house sports doctor using ultrasound which would allow the injection to take place where the inflammation is. Injections for this condition are usually comfortable and tolerated very well. Having the injection would then allow you then to progress with the exercise and rehabilitation programmes with less pain.

References

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