De Quervain Tenosynovitis: Symptoms and Treatments

De Quervain tenosynovitis is a situation in which the tendons stretching from the thumb to the wrist get inflamed. This creates friction between the tendons and the narrow passage they travel through, leading to pain at the bottom of the thumb radiating towards the forearm. The precise reasons for de Quervain tenosynovitis are not known, but it is generally thought to be due to injury to the thumb, repetitive movements (continuous grasping with the thumb) and inflammatory conditions (rheumatoid arthritis). The pain can be exacerbated by certain activities, such as racquet sports and gardening.

Symptoms of De Quervain Tenosynovitis

The most common de Quervain symptom is aching in the back of the thumb and in the area situated over the two thumb tendons. You may suddenly feel pain, or it can appear more slowly. The pain can pass into the thumb or towards the lower arm.

Moving your thumb or wrist may prove painful or difficult, especially during grasping or pinching actions. You may also have a sore or swollen wrist near the bottom of the thumb.

If the condition is left untreated, it can impede the wrist’s range of motion, and it may be tricky to use your hand and wrist correctly.

Home Remedies for De Quervain Tenosynovitis

Home remedies aim to provide pain relief, ease the swelling in the wrist and thumb and enable the thumb to function properly again. You can relieve your symptoms by trying the following:

1. Limit movement in your hand and wrist. You may need a splint to align the wrist and hand in a straight line.

2. Avoid any activities that result in pain until your symptoms have improved.

3. Apply an ice pack to the affected region for 15 minutes every 4-6 hours and keep a thin cloth between skin and pack.

4. Alternatively, use a heated pad, hot pack or warm shower on the area for 20-30 minutes, 2 or 3 times daily.

When to See a Doctor

If you have tried the following ways but still feel pain or have issues with movement, make an appointment to see your doctor.

  • Limiting the use of your damaged thumb
  • Using cold packs on the affected region
  • Taking over-the-counter anti-inflammatory medication, for example, naproxen (Aleve) and ibuprofen (Motrin IB, Advil)

Medical Treatments for De Quervain Tenosynovitis

1. Medications

Your doctor may be able to provide you with a steroid/corticosteroid injection. The steroid is administered to the wrist and base of the thumb. After the shot, you should be able to resume normal activity in the thumb and wrist within 3 weeks.

2. Ultrasound Therapy

To promote healing and ease pain and inflammation, ultrasound therapy to the tendons can be effective. In this treatment, high-frequency sound waves are passed through the tissues to micro-massage the tissues within the thumb and wrist.

3. Surgery

In more severe cases, outpatient surgery may be required. This involves your physician examining the sheath around the affected tendons and cutting open this sheath to ease the pressure on the tendon, allowing it to move more easily.

Following the operation, your doctor will give you advice about rest and rehabilitation, and how you can regain strength in your wrist and thumb. You may need to visit an occupational or physical therapist to help you adapt your daily activities to stop the returning of de Quervain tenosynovitis. Your therapist can also teach you some strengthening exercises.

4. Rehabilitation Exercises

When the initial pain has disappeared, try these rehabilitation exercises. If the pain returns, do a lower number of drills.

  • Opposition Stretch

Place your hand on a flat surface with your palm facing upwards. Bring your thumb and little finger together and hold for 6 seconds. Do this 10 times.

  • Wrist Stretch

Bend your wrist forward with the other hand by pushing the back of the hand and keep this position for 15-30 seconds. Make sure your elbow remains straight. Do three reps on each side.

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