What is de Quervain’s Tendinitis (or Tenosynovitis)?
Named after the Swiss surgeon who first identified this inflammation of the thumb and pronounced (dĕ-kār-van[h]), de Quervain’s Tendinitis (or Tenosynovitis) is one of the most common types of tendon lining inflammation.
Make a fist with your thumb placed on your palm. With your wrist suddenly bent toward the outside, your tendons are pulled throughout the tight space. If this movement is painful, you may have de Quervain’s disease.
The tendons in your hand are the tough, fibrous bands of tissue that connect the muscles of your forearm to your finger and thumb bones. They work together with your muscles to flex and extend your fingers and thumb and help you hold a pen, pick up a grocery bag, and make a fist.
With de Quervain’s tendinitis, your tendons and their coverings are swollen and cause friction within the narrow tunnel they slide through. This friction causes pain just below the base of your thumb.
What causes de Quervain’s tendinitis?
Inflammation of the tendons in your thumb can be caused by a number of things:
- Repetitive use
- Racquet sports
- Workplace tasks
- Inflammatory conditions
- Rheumatoid arthritis
Women are eight to 10 times more likely to be diagnosed with de Quervain’s than men.
What are common symptoms?
You may experience pain along the back of the thumb, directly over two thumb tendons with de Quervain’s. Your condition can occur gradually or suddenly. In either case, the pain may travel into the thumb or up the forearm.
Common symptoms include:
- Pain at the base of thumb and/or wrist
- Painful thumb and wrist motion
- Painful clicking and popping
- Swelling over the irritated area of the wrist
- Weakness with certain movements
- Burning pain or tingling over the tendons in this area
- Difficulty pinching or grasping objects
- Swelling and pain on the side of the wrist
- Direct pressure causes pain
What are my treatment options?
Your doctor may wish to inject a numbing medication into the painful area. This injection is diagnostic and can help formulate a plan tailored to your needs.
Common treatment for symptoms includes:
- Splint to stop thumb and wrist movement
- Tylenol or aspirin-type medications (ibuprofen)
Treatment to change the course of the disease includes:
- A cortisone-type steroid injection
- Surgery to open the tunnel and make more room for the tendons
How long until I’m better?
Once painful symptoms have subsided, your Summit hand surgeon will likely recommend a strengthening exercise program for your thumb and wrist. Your recovery time is dependent on your age, general health, and how long your symptoms have been present. With cases that have developed over time, de Quervain’s may take longer to respond as the disease is often more resistant to change. Summit’s hand care team will work with you to develop a treatment plan designed to get you back to your everyday active life.
Dr. Scofield explains the factors he considers when making decisions about which tendon treatment to use.
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