De Quervain’s tenosynovitis occurs when the 2 tendons around the base of your thumb become swollen. The swelling causes the sheaths (casings) covering the tendons to become inflamed. This puts pressure on nearby nerves, causing pain and numbness.
The main symptom of de Quervain's tenosynovitis is pain or tenderness at the base of your thumb. You might also feel pain going up your forearm. The pain may come on suddenly or develop slowly. It may get worse when you use your hand and thumb.
Other symptoms of de Quervain's tenosynovitis include the following:
You are much more likely to develop de Quervain's tenosynovitis if you are a woman, especially if you are 40 years of age or older. You are also more likely to develop it if one of the following is true:
To diagnose de Quervain's tenosynovitis, your doctor may do a simple test called the Finkelstein test. First, you bend your thumb so it rests across your palm. Then you make a fist, closing your fingers over your thumb. Last, you bend your wrist toward your little finger. If you have tenderness or pain at the base of your thumb, you probably have de Quervain's tenosynovitis.
Treatment for de Quervain's tenosynovitis focuses on reducing pain and swelling. It includes the following:
Your doctor may recommend injections of steroids or a local anesthetic (numbing medicine) into the tendon sheath to help reduce swelling and pain.
A physical therapist or occupational therapist can show you how to reduce stress on your wrist by changing how you move. He or she can also teach you exercises to strengthen your muscles. Most people notice improvement in 4 to 6 weeks and are able to use their hands and wrists without pain once the swelling is gone.
It is important to treat de Quervain's tenosynovitis. If this condition isn’t treated, it can permanently limit your movement or cause the tendon sheath to burst.
You might need surgery if your case is severe or if other treatments don’t relieve your pain. During outpatient surgery, the surgeon makes a small cut in the sheath around the swollen tendons. This provides more room for the tendons to move.
After surgery, you will need to do physical therapy to strengthen your wrist and thumb, and to prevent the problem from coming back. Once the area has healed and returned to full strength, you should have normal use of your hand.
Avoiding repetitive movements is the most important way to prevent de Quervain's tenosynovitis. Change your actions to reduce the stress on your wrists, and take frequent breaks to rest. Wear a brace or splint on your thumb and wrist, if necessary.
Follow the exercise routine suggested by your doctor or physical therapist. Be sure to tell him or her about any activities that cause pain, numbness or swelling.
Written by familydoctor.org editorial staff