De Quervain's Tenosynovitis

What is de Quervain's tenosynovitis?

De Quervain's tenosynovitis is a problem with the tendons on the thumb side of your wrist. Tendons are strong bands of tissue that attach muscle to bone. A sheath, or covering, surrounds the tendons that run from your wrist to your thumb. The tendons usually move easily through this sheath. Tenosynovitis is an irritation and thickening of this sheath that traps the tendons or makes it harder for the tendons to move through the sheath.

What is the cause?

De Quervain's tenosynovitis is usually caused by overusing your thumb or wrist. This is more likely in activities where you bend your wrist or use your thumb to grip something, like skiing, typing, or construction work. Other causes of this condition include wrist injuries and rheumatoid arthritis.

What are the symptoms?

Symptoms may include:

  • Pain when you move your thumb or wrist, or make a fist
  • Swelling and pain on the thumb side of your wrist
  • Feeling or hearing creaking as you move your thumb or wrist

How is it diagnosed?

Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. You may have X-rays or other scans.

How is it treated?

You will need to stop doing the activities that cause pain until you have healed. Your healthcare provider may give you a splint that covers and protects your wrist and thumb. The splint can help relieve your symptoms. If you keep having pain, your provider may give you a shot of a steroid medicine. If these treatments don't work, you may need surgery to relieve the pain.

Your healthcare provider may recommend exercises to help you heal.

How can I take care of myself?

To help relieve swelling and pain:

  • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth, on the area every 3 to 4 hours for up to 20 minutes at a time.
  • Do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over your tendon for 5 to 10 minutes. Do this several times a day while you have pain.
  • Keep your wrist up on pillows when you sit or lie down.
  • Take pain medicine, such as acetaminophen, ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

Moist heat may help relax your muscles and make it easier to move your hand and wrist. Put moist heat on the injured area for 10 to 15 minutes at a time before exercises. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Don’t use heat if you have swelling.

Follow your healthcare provider's instructions, including any exercises recommended by your provider. Ask your provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid, including how much you can lift, and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent de Quervain's tenosynovitis?

Warm-up exercises and stretching before activities can help prevent this problem. If your wrist hurts after exercise, putting ice on it may help keep it from getting injured.

Follow safety rules and use any protective equipment recommended for your work or sport.

Avoid activities that overuse your thumb or wrist.

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Published by RelayHealth.
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