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Home » Anatomy » De Quervain’s Tenosynovitis: Causes, Symptoms, Diagnosis, and Treatment

De Quervain’s Tenosynovitis: Causes, Symptoms, Diagnosis, and Treatment

De Quervain’s tenosynovitis definition

De Quervain’s tenosynovitis a condition that affects the tendons on the thumb side of the wrist is characterized by pain, swelling and discomfort. This condition can impact individuals of all ages and occupations and it often arises due to repetitive hand and wrist movements. In this article, we will delve into the causes, symptoms, diagnosis, and treatment options for De Quervain’s tenosynovitis.

Tendons involved in De Quervain’s tenosynovitis

These tendons are known as the abductor pollicis longus and extensor pollicis brevis tendons are responsible for moving the thumb away from the palm and extending it.

Causes of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is primarily caused by irritation and inflammation of the tendons located on the thumb side of the wrist. Repetitive hand and wrist movements especially those involving gripping, pinching and twisting motions can lead to irritation of these tendons resulting in the development of tenosynovitis.

Symptoms of De Quervain’s Tenosynovitis

Individuals with De Quervain’s tenosynovitis often experience a range of symptoms that can gradually worsen over time.

The hallmark symptom is pain that radiates from the wrist to the forearm. This pain is often exacerbated when gripping objects, making a fist or turning the wrist. Swelling and tenderness at the base of the thumb are also common and some individuals might notice a “creaking” sensation when moving the thumb.

Diagnosing De Quervain’s Tenosynovitis

Diagnosing De Quervain’s tenosynovitis typically involves a comprehensive evaluation of the patients medical history along with a physical examination. A healthcare provider will often perform the Finkelstein test a simple maneuver that helps to diagnose the condition. During this test the patient makes a fist with the thumb tucked inside the fingers and then the wrist is bent towards the little finger. If this movement elicits pain on the thumb side of the wrist it is a strong indicator of De Quervain’s tenosynovitis.

In some cases imaging studies such as ultrasound might be recommended to rule out other potential causes of the symptoms. These studies can help visualize the affected tendons and assess the degree of inflammation.

Treatment Options

Conservative Treatments

In the early stages of De Quervain’s tenosynovitis healthcare providers usually recommend conservative treatments. These options aim to alleviate pain and reduce inflammation without surgical intervention.

  1. Rest and Immobilization: Resting the affected hand and avoiding repetitive motions can help the tendons heal. Immobilization through the use of splints or braces can also aid in reducing strain on the inflamed tendons.
  2. Ice Therapy: Applying ice to the affected area can help alleviate pain and reduce swelling. Cold packs can be applied for 15 to 20 minutes at a time several times a day.
  3. Anti-Inflammatory Medications: Non steroidal anti-inflammatory drugs (NSAIDs) can provide relief from pain and inflammation. However it’s important to use them under medical guidance.

Physical Therapy and Exercises

Physical therapy plays a crucial role in the treatment of De Quervain’s tenosynovitis. A trained therapist can guide patients through specific exercises aimed at improving the flexibility and strength of the affected tendons. These exercises can also help prevent recurrence of the condition.

Injections

If conservative measures do not provide sufficient relief corticosteroid injections may be consider. These injections are administered directly into the inflamed tendon sheath to reduce inflammation and relieve pain. Its worth noting that while injections can provide rapid relief their effects might be temporary.

Surgical Intervention

In cases where conservative treatments and injections do not yield satisfactory results surgical intervention might be recommend. The surgical procedure involves creating more space for the affected tendons by cutting the constricting tendon sheath. This alleviates pressure on the tendons and allows them to move more freely. Surgical treatment is often effective in resolving persistent symptoms.

Prevention of De Quervain’s Tenosynovitis

Preventing De Quervain’s tenosynovitis involves adopting certain lifestyle and ergonomic practices especially for individuals who engage in repetitive hand and wrist movements. Some preventive measures include:

  • Taking regular breaks during activities that involve repetitive wrist and hand motions.
  • Practicing proper hand and wrist posture while typing using a computer or engaging in other activities.
  • Using ergonomic tools and equipment that minimize strain on the wrists and hands.
  • Incorporating hand and wrist stretches into daily routines to maintain flexibility.

De Quervain’s Tenosynovitis After Pregnancy

De Quervain’s tenosynovitis can be a notable concern for new mothers after pregnancy. This condition often referred to as “mommy thumb” can arise due to the repetitive hand and wrist movements involved in caring for an infant. Lifting, holding and feeding a baby can strain the tendons on the thumb side of the wrist leading to irritation and inflammation. The hormonal changes that occur during pregnancy and the postpartum period can also contribute to the development of tenosynovitis. The combination of increased demands on the hands and the bodys physiological changes can make new mothers more susceptible to this condition. Therefore recognizing the symptoms and taking steps to manage them is crucial for ensuring that caring for a newborn is as comfortable and pain free as possible.

Conclusion

De Quervain’s tenosynovitis can significantly impact an individuals daily life by causing pain, discomfort and limitations in hand and wrist movement. Recognizing the symptoms early and seeking appropriate medical attention can lead to effective management and a quicker recovery. With a combination of conservative treatments, physical therapy and in some cases surgical intervention individuals can regain optimal hand function and resume their regular activities without hindrance. Moreover adopting preventive measures can reduce the risk of developing this condition.

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