HAND/WRIST
De Quervain’s tenosynovitis- what is it?
De Quervain’s tenosynovitis is swelling of the tendons that run along the side of the wrist and attach to the base of the thumb. The role of these tendons is to perform outward motion of the thumb. When the sheath that these tendons run through becomes inflamed, it constricts the tendons and causes wrist pain.
What are the symptoms?
Patients with De Quervain’s tenosynovitis may experience pain along the thumb side of the wrist with movement of the thumb, formation of a fist, grasping or gripping items, turning of the wrist, and lifting something in front of you with thumbs pointed toward the ceiling. Swelling may or may not be present over the wrist.
Diagnosis:
A diagnosis is made by your provider during your physical exam. Your provider will likely obtain an x-ray to rule out fracture or osteoarthritis.
Causes of De Quervain’s tenosynovitis:
• De Quervains is more common in women than men and affects people most commonly in their 40’s-50’s.
• It may be associated with overuse activities of the thumb and wrist.
• May be associated with pregnany and postpartum. For women in the postpartum period, activities of caring for a newborn such as lifting them in front of you with hands pointed toward the ceiling, may lead to these symptoms.
Treatment:
Most cases will resolve without surgical intervention. Treatment begins with: NSAIDS, wrist splinting, rest, activity modification and possibly a corticosteroid injection.
For those with failure of conservative management, surgical invention involves a first dorsal compartment release which is a quick, outpatient procedure where the surgeon opens the sheath covering the tendons, releasing the pressure.
Reference:
OrthoInfo. American Academy of Orthopedic Surgeons. 2023. De Quervain’s Tenosynovitis. https://orthoinfo.aaos.org/en/diseases--conditions/de-quervains-tendinosis/
