DeQuervain’s Tendonitis Defined
A painful condition that affects tendons on the thumb-side of the wrist, DeQuervain’s tendonitis restricts patents’ ability to turn their wrist, grasp objects in their hands, and/or make a fist.
What Causes DeQuervain’s Tendonitis?
Scientists still have much to learn about the precise cause of DeQuervain’s tendonitis, but the pain and swelling associated with the disorder are a result of localized inflammation of tendons and/or tendon sheaths in the wrist and thumb area. This inflammation is triggered and aggravated by repetitive hand or wrist movements such as those associated with general office work, housekeeping, and child-rearing duties. Hobbies and sports (gardening, needlepoint, carpentry, and playing golf or racquet sports) have also been associated with DeQuervain’s tendonitis.
Outside of general strain and overuse, other potential causes of DeQuervain’s tendonitis include…
- Traumatic injury to your wrist or tendon
- Scar tissue that can significantly restricts tendon movement
- Rheumatoid arthritis and other forms of inflammatory arthritis
What Are the Symptoms of DeQuervain’s Tendonitis?
In addition to localized pain/swelling and difficulty using the thumb to grasp or pinch, symptoms of DeQuervain’s tendonitis may include a sticking or “stop-and-go” sensation in the thumb during movement. If left untreated for a long period of time, the condition can worsen to the point that pain begins to spread further into the thumb and across the entire wrist. In extremely severe cases, pain can radiate far up the forearm. If you are experiencing symptoms that are consistent with DeQuervain’s tendonitis, you can try limiting use, applying cold to the affected area, and using over the counter non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen. See a doctor as soon as possible if these measures fail to alleviate your symptoms.
How Can DeQuervain’s Tendonitis Be Medically Treated?
Treatment for DeQuervain’s tendonitis attempts to reduce inflammation, preserve movement, and prevent recurrence. Before resorting to surgery, a hand doctor will typically begin with a treatment regimen that includes some combination of…
- Localized steroid injection – Typically effective within two weeks, these injections can be repeated if necessary.
- Activity modification – Avoiding the activities that trigger and/or aggravate the condition.
- Immobilization – Either limiting movement through a splint/brace or keeping the thumb and wrist entirely straight by applying a cast.
- Occupational therapy – Exercises and movement guidance by a trained professional that can be helpful in conjunction with surgery or without it.
For more serious cases of DeQuervain’s tendonitis that do not respond to non-operative treatment, doctors often recommend surgery. After inspecting the sheath that surrounds the affected tendon or tendons, a surgeon will make a small incision in the wrist to access tendon sheaths, opening them as necessary to release pressure and friction. Once opened, tendons can generally glide freely, eliminating the inflammation that is the root cause of all DeQuervain’s tendonitis issues. This procedure is typically accomplished on an outpatient basis with no need for general anesthesia.