Summary about Disease
De Quervain tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist. It causes pain and tenderness along the thumb side of the wrist, especially when forming a fist, grasping, or turning the wrist. It's caused by irritation or swelling of the tendons that control thumb movement.
Symptoms
Pain near the base of your thumb
Swelling near the base of your thumb
Difficulty moving your thumb and wrist when grasping or pinching
A "sticking" or "catching" sensation in your thumb when you move it
Tenderness to the touch along the thumb side of your wrist.
Causes
De Quervain tenosynovitis is generally caused by chronic overuse of the wrist. Activities that involve repetitive hand or wrist movements, such as:
Repetitive grasping
Gardening
Playing certain sports (like racket sports)
Lifting a baby frequently
Typing or texting extensively Other potential causes or contributing factors include:
Direct injury to the wrist or thumb
Arthritis
Scar tissue
Pregnancy
Inflammatory conditions
Medicine Used
Pain relievers: Over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation. Prescription pain relievers may be needed in some cases.
Corticosteroid injections: A corticosteroid injection into the tendon sheath can reduce inflammation and pain.
Is Communicable
No, De Quervain tenosynovitis is not communicable. It is not caused by an infection and cannot be spread from person to person.
Precautions
Avoid repetitive movements: Identify and avoid activities that aggravate your pain.
Take breaks: During activities that involve repetitive hand or wrist movements, take frequent breaks to rest your hands.
Use proper ergonomics: Ensure your workstation is set up correctly to minimize strain on your wrists.
Use assistive devices: Consider using tools with larger handles or adaptive equipment to reduce strain.
Strengthen and stretch: Perform regular stretching and strengthening exercises for your hands, wrists, and forearms.
Ice/Heat: Apply ice packs to reduce inflammation or heat for muscle relaxation.
How long does an outbreak last?
The duration of a De Quervain tenosynovitis "outbreak" (episode of symptoms) varies greatly. With conservative treatment (rest, splinting, pain relievers), symptoms may improve within a few weeks to months. If left untreated, it can become chronic and last for several months or even years. Corticosteroid injections can provide relief for weeks to months, but symptoms may return. Surgery is generally considered if other treatments fail.
How is it diagnosed?
Diagnosis is typically based on:
Physical examination: A doctor will examine your hand and wrist, checking for pain, swelling, and tenderness.
Finkelstein test: This test involves bending your thumb across your palm and then bending your wrist toward your little finger. If this causes sharp pain on the thumb side of your wrist, it's a strong indication of De Quervain tenosynovitis.
Imaging Tests: X-rays may be taken to rule out other conditions such as arthritis or a fracture.
Timeline of Symptoms
The timeline of symptoms can vary, but generally follows this pattern:
Initial: Gradual onset of pain on the thumb side of the wrist, which may be mild and only noticeable during certain activities.
Progression: Pain increases and becomes more constant, potentially radiating into the thumb or forearm. Swelling and tenderness develop.
Advanced: Pain interferes with daily activities, making it difficult to grip, pinch, or turn the wrist. A "sticking" or "catching" sensation may occur.
Chronic: If untreated, the condition can persist for months or years, with persistent pain and limited function.
Important Considerations
Early diagnosis and treatment are crucial to prevent the condition from becoming chronic.
It's important to identify and modify activities that aggravate your symptoms.
Follow your doctor's instructions regarding rest, splinting, and exercises.
Surgery is generally a last resort, but it can be effective in relieving symptoms if other treatments fail.
Even after treatment, symptoms may recur, so it's important to continue practicing good hand and wrist ergonomics.