De Quervains Tendinitis
De Quervain's tendinitis is a condition that develops from irritation or swelling of the tendons along the thumb side of the wrist. This irritation causes the compartment (lining) around the tendon to swell, changing the shape of the compartment and making movement of the tendons difficult. The swelling can cause pain and tenderness along the thumb side of the wrist, usually noticed when forming a fist, grasping items or turning the wrist.
The Center for Plastic and Reconstructive Surgery offers a full range of surgical procedures for de Quervain's tendinitis. Surgeons use leading-edge technology and world-class surgical techniques for patients with de Quervain's tendinitis.
Pain over the thumb side of the wrist is the primary symptom of De Quervain's tendinitis. The pain may appear either gradually or suddenly, and it can be felt in the wrist or forearm. The pain is usually worse with use of the hand and thumb, especially when forcefully grasping items or twisting the wrist.
Swelling over the thumb side of the wrist is noticed and may be accompanied by a fluid-filled cyst in this region. An occasional "catching" or "snapping" may also be noticed when moving the thumb. The pain and swelling may make move the thumb and wrist difficult, and irritation of the nerve lying on top of the tendon sheath may cause numbness on the back of the thumb and index finger.
A Finkelstein test is generally performed to diagnose this condition. In this test, the patient makes a fist with the fingers over the thumb, and the wrist is bent in the direction of the little finger. This test can be quite painful for the person with De Quervain's tendinitis, but tenderness directly over the tendons on the thumb side of the wrist is the most common finding.
The goal of treatment is to relieve the pain caused by the irritation and swelling. In some cases, your doctor may recommend resting the thumb and wrist by wearing a splint. Anti-inflammatory medication taken by mouth or injected into the tendon compartment may help reduce the swelling and relieve the pain. In some cases, simply not doing the activities that cause pain and swelling may allow the symptoms to go away on their own.
When symptoms are severe or do not improve, surgery may be recommended. The surgery performed opens the compartment (covering) to make more room for the irritated tendons. Normal use of the hand can usually be resumed once comfort and strength have returned. Your hand surgeon can advise you on the best treatment for your situation.