The tendons in your wrist are affected by De Quervain’s tenosynovitis, which is a painful ailment. It happens when the two tendons at the base of your thumb swell. The sheaths (casings) that cover the tendons become inflamed and cause a narrowing of the passage through which the tendons run. This causes pain specifically with certain repetitive movements like lifting your child.
Although the actual aetiology of de Quervain’s tenosynovitis is unknown, any activity that requires repeated hand or wrist movement, such as gardening, golf, or racket sports, or lifting your child, might aggravate the condition.
Symptoms
Sharp or dull Pain and swelling or discomfort at the base of your thumb is the most common symptom of de Quervain’s tenosynovitis. You may also have soreness up your forearm. The discomfort may grow gradually or unexpectedly. This can become quite intense and restrict your function.
Other symptoms are:
- The base of your thumb hurts.
- The base of your thumb is swollen.
- When you’re performing something that requires grabbing or pinching, it’s difficult to move your thumb and wrist.
When you move your thumb, it feels sticky. If you wait too long to cure your problem, the discomfort may move to your thumb, back into your forearm, or both. Pinching, clutching, and other thumb and wrist actions worsen the discomfort.
Causes
Chronic wrist overuse, alterations in your hormone levels, swelling and repetitive movements are the most common causes of de Quervain’s tenosynovitis. Lifting a youngster into a car seat is one regular activity that causes it. Lifting large grocery bags by the handles is another possible cause.
You are more prone to de Quervain’s tenosynovitis:
- If you are a woman (new mothers develop it about 6 weeks after delivery
- If repetitive hand and wrist motions are a part of your hobbies or employment.
- If our wrist has been injured, tendon mobility can be restricted by inflammation and swelling.
Diagnosis
Your doctor may do a simple test to diagnose de Quervain’s tenosynovitis. The Finkelstein test is what it’s called. You begin by bending your thumb so that it lays over your palm. Then you close your fingers around your thumb and create a fist. Finally, you bend your wrist in the direction of your little finger. De Quervain’s tenosynovitis is characterised by discomfort or pain near the base of the thumb.
Other tests, such as X-rays, are typically not required to diagnose the problem but may at times be helpful to differentiate other causes.
Treatment
De Quervain’s tenosynovitis is treated by lowering discomfort and swelling. Treatment options include:
- Heat or ice can be applied to the affected region.
- Using a nonsteroidal anti-inflammatory medication (NSAID) either topically to the region or in oral tablet form (if not contra indicated- asthma/ allergies/ stomach ulcers etc.) can help with the pain
- Activity modification by identifying movements that cause discomfort and oedema and avoiding them. Those that need repetitive hand and wrist motions should be avoided at all costs.
- To rest your thumb and wrist, wear a splint as advised by your hand therapist or hand surgeon
- steroid injections are quite effective and are often used to manage the problem and are usually injected under ultrasound guidance into the tendon compartment.
When should you see a hand surgeon?
if you’re already tried:
- Avoid utilizing the thumb that is affected.
- Using ice on the affected area
- non-steroidal anti-inflammatory medications
If you’re still having difficulties with pain or function a hand surgeon can help advise you on the various non operative options, recommend a good hand therapist and guide you on the surgical option should the non-operative options fail. The operation when required is curative.