Pain in Your Wrist or at the Base of Your Thumb? It may be DeQuervain’s Tendonitis
While a hand doctor treats many cases of DeQuervain’s tendonitis, many people have never heard of this condition.
DeQuervain’s tendonitis affects tendons, which are tough bands of tissue that connect muscles to bones. Tendons work like pulleys to move bones across joints.
Specifically, DeQuervain’s tendonitis affects the tendons that attach to the thumb. These tendons go from the thumb through a fleshy tunnel, known as a tendon sheath, on the side of the wrist and work like a lever to control the bone at the base of the thumb. Normally, synovial fluid lubricates this tunnel to allow smooth and painless movement of the tendon within the sheath.
In medical terminology, the suffix “-itis” means swelling. Tendonitis, then, is swelling of a tendon. Tendons normally fit snugly within their tendon sheaths, so there is not much room for a swollen tendon to move within a sheath. Swollen tendons cause friction as they slide through the sheath, and this friction causes pain.
Repetitive actions or chronic overuse of the hand may lead to DeQuervain’s tendonitis. Certain activities increase the risk for developing DeQuervain’s tendonitis, including carpentry, office work and needlework. While anyone can develop this type of tendonitis, it is most common in middle-aged women. DeQuervain’s tendonitis is associated with pregnancy and rheumatoid arthritis.
Diagnosis and Treatment of DeQuervain’s Tendonitis
Hand doctors diagnose DeQuervain’s tendonitis with a comprehensive evaluation that includes assessment of the symptoms, a review of your medical history, and examination of your hand.
Symptoms of DeQuervain’s tendonitis include pain over the thumb side of the wrist; discomfort may spread up the forearm. Pain may develop suddenly or gradually, and be worse when you use your hand or wrist. The pain may be especially bad when you forcefully grab an object or twist it with your wrist. Swelling may develop over the thumb side of the wrist. A fluid-filled cyst may appear near the swelling. You may experience a snapping or catching sensation when you move your thumb. Pain may make it difficult to move your thumb.
Your hand surgeon may perform a Finkelstein test, which involves moving your wrist and thumb from side to side. X-rays, magnetic resonance imaging (MRI), and other tests can rule out other causes, such as arthritis.
Treatment for DeQuervain’s tendonitis includes steroid injections, anti-inflammatory medications, splinting and modifying activities. Surgical treatment may be necessary if non-surgical approaches fail. The goal of surgery is to open the covering of the sheath to make more room for the inflamed tendon.
For more information on DeQuervain’s tendonitis, make an appointment with your Florida hand doctor.