de quervain’s tenosynovitis
What is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a painful inflammation of the tendon sheath in the thumb side of the wrist. De Quervain’s Tenosynovitis is more common in middle aged women (between 30-50) and is often associated with repetitive motion tasks or recent childbirth.
What are the symptoms of De Quervain’s Tenosynovitis?
Symptoms of De Quervain’s Tenosynovitis are going to include wrist pain on the thumb side of the wrist that worsens with movement. There can be swelling and pain at the base of the thumb and wrist, and the tendon can get stuck in the tendon sheath causing a clicking sensation or a catching sensation. There is a test to determine if a patient has De Quervain’s Tenosynovitis that consists of making a thumbs up gesture at the ceiling for orientation. Making a fist in this postion with the fingers wrapping around the thumb and gentle bending the hand towards the floor. If this gesture induces pain then De Quervain’s Tenosynovitis could be the cause.
What is the treatment for De Quervain’s Tenosynovitis?
Dr. Quervain’s Tenosynovitis is commonly treated conservatively and responds well. In some people conservative treatment fails, or doesn’t last long. For cases that don’t respond to conservative treatment there is a surgical intervention called a De Quervain’s Tenosynovitis release.
Conservative Treatment of De Quervain’s Tenosynovitis
Conservative treatment of De Quervain’s Tenosynovitis will start with resting the tendon so that it may have time to reduce the inflammation. A simple splint that immobilizes the thumb for two to three weeks along with over the counter NSAIDs as needed can go a long way. If splinting and resting the tendon does not offer relief a trip to a hand specialist for a corticosteroid injection can offer relief in addition to a splinting regimen. This treatment can be repeated but the physician will need to keep close track of how often you are receiving steroids due to their harmful side effects from excessive use. In people whose disease has developed gradually, de Quervain’s is usually more resistant to treatment. For these people, it may take longer to find relief. If steroids are unable to control the symptoms without being abuse surgical intervention would be something to discuss with your physician.
DE QUERVAIN’S tenosynovitis release
Surgical release of the tight covering of the affected tendon eliminates the friction that causes inflammation, restoring the tendons’ smooth gliding capability. Surgery for de Quervain’s disease is an outpatient procedure and rarely utilized due to non-operative interventions being very effective.
After surgery, your doctor will recommend an exercise program, or physical therapy, to strengthen your thumb and wrist. Recovery times vary, depending on your age, general health, and how long the symptoms have been present.
