De Quervain’s tenosynovitis

De Quervain’s tenosynovitis
0 25 October 2017

drsivakumar

Definition

De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain’s tenosynovitis, it will probably hurt when you turn your wrist, grasp anything or make a fist.

Although the exact cause of de Quervain’s tenosynovitis isn’t known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports, or lifting your baby — can make it worse.

Symptoms

symptoms of de Quervain’s tenosynovitis include:

  • Pain near the base of your thumb
  • Swelling near the base of your thumb
  • Difficulty moving your thumb and wrist when you’re doing something that involves grasping or pinching
  • A “sticking” or “stop-and-go” sensation in your thumb when moving it

If the condition goes too long without treatment, the pain may spread further into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

Causes

Chronic overuse of your wrist is commonly associated with de Quervain’s tenosynovitis.

Tendons are rope-like structures that attach muscle to bone. When you grip, grasp, clench, pinch or wring anything in your hand, two tendons in your wrist and lower thumb normally glide smoothly through the small tunnel that connects them to the base of the thumb. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement.

Other causes of de Quervain’s tenosynovitis include:

  • Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons.
  • Inflammatory arthritis, such as rheumatoid arthritis.

Risk factors

Risk factors for de Quervain’s tenosynovitis include:

  • Age. If you’re between the ages of 30 and 50, you have a higher risk of developing de Quervain’s tenosynovitis than do other age groups, including children.
  • Sex. The condition is more common in women.
  • Being pregnant. The condition may be associated with pregnancy.
  • Baby care. Lifting your child repeatedly involves using your thumbs as leverage and may also be associated with the condition.
  • Jobs or hobbies that involve repetitive hand and wrist motions. These may contribute to de Quervain’s tenosynovitis.

Complications

Untreated de Quervain’s tenosynovitis might make it hard to use your hand and wrist properly and limit your wrist’s range of motion.

Treatments and drugs

Treatment for de Quervain’s tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence.

Therapy

Initial treatment of de Quervain’s tenosynovitis may include:

  • Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
  • Avoiding repetitive thumb movements as much as possible
  • Avoiding pinching with your thumb when moving your wrist from side to side
  • Applying ice to the affected area

You may also see a physical or occupational therapist. These therapists may review how you use your wrist and give suggestions on how to make adjustments to relieve stress on your wrists. Your therapist can also teach you exercises for your wrist, hand and arm to strengthen your muscles, reduce pain and limit tendon irritation.

Surgery

If your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure so your tendons can glide freely.

Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.

Lifestyle and home remedies

If you don’t need surgery, caring for your condition is much the same as preventing it:

  • Avoid moving your wrists the same way repeatedly.
  • Wear a brace or splint if suggested by your doctor.
  • Follow through with recommended exercises.
  • Note activity that causes pain, swelling or numbness in your thumb and wrist, try to avoid it, and share that information with your doctor.
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