De Quervain's Tenosynovitis

What is de Quervain's tenosynovitis?

De Quervain's tenosynovitis is a painful condition that affects the tendons on the thumb side of your wrist. Tendons, are strong bands of connective tissue that attach muscle to bone. A sheath, or covering, surrounds the tendons that go to your thumb. Tenosynovitis is an irritation of this sheath.

How does it occur?

De Quervain's tenosynovitis is usually cause by overusing your thumb or wrist. This is more likely in activities when your wrist is bent and you use your thumb to grip something (such as when you ski or hammer).

Other causes of this condition include:

• wrist injuries
• rheumatoid arthritis.

What are the symptoms?

Symptoms may include:

• pain when you move your thumb or wrist
• pain when you make a fist
• swelling and pain on the thumb side of your wrist
• feeling or hearing creaking as the tendon moves

How is it diagnosed?

Your healthcare provider will examine your wrist and thumb and check for areas that are tender and painful to move. You may have an X-ray to be sure you don't have a broken bone.

How is it treated?

The first treatment is a splint that will cover your wrist and thumb. You need to protect your thumb and wrist. Treatment may also include:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on your thumb and wrist every 3 to 4 hours, for up to 20 minutes at a time.
• You could also do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over your tendon for 5 to 10 minutes. Do this several times a day while you have pain.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Your provider may give you an injection of a corticosteroid medicine.
• Follow your provider’s instructions for doing exercises to help you recover.

How long will the effects last?

The length of recovery depends on factors such as your age, health, and if you have had a previous injury. Recovery time also depends on the severity of the injury. A mild injury may recover within a few weeks, but a severe injury may take 6 weeks or longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your wrist recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible.

You need to stop doing the activities that cause pain until the tendon has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover. You may return to your normal activities when it is no longer painful to move your thumb or wrist. You may need to do activities wearing a supportive splint until you no longer have symptoms.

How can I prevent de Quervain's tenosynovitis?

Avoiding activities that overuse your thumb or wrist may prevent de Quervain's tenosynovitis.