De Quervain’s Tenosynovitis (Wrist Tendinitis)

De Quervain’s tenosynovitis is a disorder that causes swelling of the tendons on the wrist’s thumb side near the base of the thumb. It occurs when these tendons are compressed within their sheath, resulting in pain and limited mobility.

Signs and Symptoms

De Quervain’s tenosynovitis is characterized by the following symptoms:

• Pain on the wrist’s thumb side: Pain is the main symptom of De Quervain’s tenosynovitis. It can appear gradually or unexpectedly and frequently travels up the forearm from the wrist. Gripping, lifting, and twisting the wrist are activities that usually make the pain worse.
• Swelling: A fluid-filled cyst may occasionally accompany swelling in the affected region.
• A sensation of catching or snapping: A catching or snapping sensation may result from thumb movement.
• Thumb and wrist movement difficulty: Swelling and pain can limit the range of motion and make day-to-day tasks difficult to achieve.

Causes

Some of the factors that can contribute to the development of De Quervain’s tenosynovitis include:

• Overuse: Excessive thumb and wrist motion might cause tendon irritation.
• Pregnancy and breast-feeding: The condition may be exacerbated by hormonal changes that occur during pregnancy and lactation.
• Rheumatoid arthritis: People who have rheumatoid arthritis are more vulnerable.
• Age and sex: Women are more likely than men to have the condition, and those between the ages of 40 and 50 are also at high risk.

Diagnosis and Tests

The Joint Pain Clinic often diagnoses De Quervain’s tenosynovitis by applying pressure to the thumb side of the wrist to assess pain and swelling. A key diagnostic test is the Finkelstein/Eichhoff test, where the patient:

• Puts their thumb inside the palm.
• Wraps the other fingers around the thumb.
• Twists the wrist toward the little finger.

If this movement causes pain, then it highly indicates De Quervain’s tenosynovitis.

Treatment

Our treatment options for De Quervain’s tenosynovitis include non-surgical and surgical approaches, depending on symptom severity.

Non-surgical treatment options:

• Avoiding movements that worsen symptoms.
• Applying ice to reduce swelling.
• Using a splint to support and immobilize the wrist.
• Physical therapies.
• Anti-inflammatory drugs to help relieve discomfort and swelling.
• Corticosteroid injections to ease inflammation in the tendon sheath.

Surgical treatment options:

Depending on how well you respond to non-surgical treatment options and how severe your pain symptoms are, your doctor may suggest surgery. In order to reduce pressure on the tendon and enable unrestricted wrist movement, this surgical technique entails opening or cutting the inflamed area of the tendon sheath. For a month following the surgery, you must wear a wrist splint that allows your thumb and fingers to move freely. Additionally, your surgeon will guide you on wrist-strengthening exercises.

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