De Quervain Tenosynovitis

What is a De Quervain Tenosynovitis?

De Quervain’s Syndrome or tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. Hand and wrist motion causes pain, especially with forceful grasping or twisting. At times, sharp pain may be experienced when stretching the thumb away from the palm. Specifically, the first dorsal compartment tendons Abductor Pollicis Longus(APL) and Extensor Pollicis Brevis(EPB) are affected.

Causes:

The cause of de Quervain’s tenosynovitis is thought to be due to mechanical overload of the tube with increased thumb use or loading. Any activity that involves repetitive wrist motion may exacerbate the pain. This may include lifting a baby, working in the garden or playing tennis or golf.

De Quervain’s tenosynovitis has been reported up to six times more frequently in women, especially during or immediately following pregnancy. 

Signs and Symptoms:

Pain over the thumb side of the wrist is the main symptom. The pain may occur gradually or suddenly. The pain is generally localised over the thumb side of the wrist. Swelling over the area may also be noticed. There may be occasional catching or snapping when moving the thumb. 

Treatment:

Once the diagnosis of de Quervain’s tenosynovitis has been confirmed, initial treatment is non surgical. This may include rest, splinting and anti-inflammatory medications. Corticosteroid injections may be indicated. Dr Watson recommends that the injection be performed by an individual familiar with the anatomy of the region. 

In more severe cases, surgery may be indicated to release the first dorsal compartment tendons. The surgery opens the tunnel to allow more room for the irritated tendons