De Quervain's Tenosynovitis(Thumb Tendonitis)

Overview

What Is De Quervain's Tenosynovitis?

De Quervain's tenosynovitis causes pain in tendons around the base of the thumb, on the inside of the wrist and forearm. Some doctors call it de Quervain’s tendinosis. Both terms refer to inflammation along the thumb.

De Quervain’s affects the thumb’s tendons – cords of tissue that connect muscles and bones. When the tendons around the base of the thumb are irritated or constricted, they swell. This swelling can cause pain, tenderness and weakness in the hand.

Sometimes people call de Quervain’s “mommy thumb,” because new mothers can strain their thumbs from lifting their newborns repeatedly. Just as often, people experience de Quervain syndrome after helping someone move on the weekend.

Treatment for de Quervain’s ranges from splints and steroids to minimally invasive surgery. At Aurora Health Care, we can help you find the right treatment option so you can get relief – and get back to your life.

The Aurora Difference

Your Experts in De Quervain’s Relief

De Quervain syndrome is fairly easy to diagnose. Still, it’s important to see an experienced doctor to be sure the diagnosis isn’t confused with another thumb or wrist condition.

When you choose Aurora for de Quervain’s care, you can expect:

  • Expert hand and wrist surgery: Many of our orthopedic surgeons have fellowship training in hand surgery. These doctors have additional training beyond medical school in caring for the tendons, joints and muscles of the hand.
  • On-site occupational therapy: Our hand surgeons and other orthopedic specialists work directly with occupational therapists, and many are right in their clinics. You’ll benefit from a comprehensive care team working together to help you feel better, fast. Learn more about occupational therapy.
  • Hand therapy: Some physical therapists and occupational therapists achieve certified hand therapist status. This means they’ve spent thousands of hours specializing in the hand. Hand therapy can improve your hand function and reduce pain. Learn more about hand therapy.
  • Hand expertise in Milwaukee and beyond: Our Hand Service Program provides specialized hand care, with fellowship-trained hand surgeons available from Green Bay to Kenosha. Our specialists are experts at treating conditions involving your arms and hands, including problems with your fingers and thumbs.

Symptoms & Causes

Signs & Causes of De Quervain's Tenosynovitis

Tendons normally slide through a flexible tunnel, called a sheath, to connect and support the thumb. When the tendons swell or the sheath thickens because of pressure or inflammation, it can hurt to move your thumb or wrist. This condition may happen because of repetitive activities like playing racket sports or golf or lifting children.

De Quervain's Tenosynovitis Symptoms

The universal symptom of de Quervain’s tenosynovitis is pain on the thumb side of the wrist, which sometimes extends up the forearm.

If you have thumb tendonitis from de Quervain’s, you may also notice:

  • Swelling on the thumb side of the wrist
  • A catching or snapping feeling when you move the thumb
  • Thumb and wrist stiffness
  • Thumb weakness and trouble lifting things – even a coffee cup

Eventually, you may notice a squeaking or snapping noise (called crepitus) as the tendons move through the narrowed tunnel.

What Causes De Quervain's Tenosynovitis?

Doctors aren’t completely sure what causes de Quervain's tenosynovitis. Overuse is the likeliest cause. Inflammation can arise from repeated hand and thumb motions like lifting with the thumb up, squeezing, pinching, gripping and wringing.

Scar tissue from an injury or surgery may narrow the tendon’s tunnel, increasing the risk of thumb tendonitis. Inflammatory diseases like rheumatoid arthritis (rheumatoid pannus) could also be a cause.

 Diagnosis

How Is De Quervain's Tenosynovitis Diagnosed?

To check for de Quervain's tenosynovitis, your doctor will probably ask you to do a simple in-office check called the Finkelstein test.

To complete the Finkelstein test, you’ll:

  • Bend your thumb in against your palm
  • Close your fingers over your thumb to make a fist
  • Bend your wrist sideways, toward your little finger and the floor

If de Quervain’s is the cause, you’ll feel tendon pain on the thumb side of the wrist during this test.

Treatment

Treating De Quervain’s Tenosynovitis Without Surgery

You may be able to recover from de Quervain’s tenosynovitis with home treatment. Changing your activity, resting the sore thumb, and treating thumb tendonitis with anti-inflammatory medications and heat or ice can improve the pain in a few weeks.

Depending on your injury, you may need additional treatment like:

  • Splints: A special splint called a thumb spica splint can support your wrist and thumb so they can heal.
  • Pain management: We use non-narcotic medications and integrative care like acupuncture to manage pain so you can heal. Find out more about orthopedic pain we treat.
  • Steroid (cortisone) injections: Injected medications can deliver pain relief or lubrication directly to the inflamed area. Learn more about injections for joint pain.

Surgery for De Quervain’s Tenosynovitis

If noninvasive treatment doesn’t improve your symptoms, or if the condition is severe, you may need thumb surgery to relieve de Quervain’s tenosynovitis.

Your surgeon will open the thumb compartment (the tunnel that contains the tendons) to give the irritated tendons more space to move. When the tunnel heals, it will leave more room for the tendons. The surgery is brief, but full recovery takes several months.

We’ll recommend hand therapy or occupational therapy after surgery to regain your thumb function and learn healthy ways of using your hand. Learn more about orthopedic physical therapy.

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