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.
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:
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.
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:
Eventually, you may notice a squeaking or snapping noise (called crepitus) as the tendons move through the narrowed tunnel.
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.
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:
If de Quervain’s is the cause, you’ll feel tendon pain on the thumb side of the wrist during this test.
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:
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.