De Quervain’s Syndrome

Leading Orange County Hand Surgeons Treating Thumb Tendonitis

de Quervain’s tendonitis, also called de Quervain’s tendinosis or de Quervain’s tenosynovitis, causes pain at the base of the thumb pain as a result of irritated or constricted tendons, which are thick bands of connective tissue that attach muscles to bone. The condition occurs in women 8 to 10 times more often than men and is caused by the inflamed extensor tendons of the thumb and wrist.

Causes of de Quervain’s Tendonitis

Pain from de Quervain’s tendonitis usually results from overuse, a direct blow to the thumb, or inflammatory conditions such as arthritis. New mothers are also prone to de Quervain’s tendonitis due to fluctuating hormones associated with pregnancy and from repetitive hand positioning to lift and cradle an infant. Athletes who engage in sports that involve repetitive grasping motions of the hands, such as tennis, golf, or rowing, are also at greater risk. Jobs that require a sideways motion of the wrist while gripping the thumb can aggravate this condition. Jobs requiring the use of a hammer or gardening have been associated to this condition. Even excessive text messaging or gaming has been linked to cases of de Quervain’s tendonitis.

Symptoms of de Quervain’s Tendonitis

You may have De Quervain’s tendonitis if you notice the following symptoms:

• Pain and swelling at the thumb-side of the wrist that makes it more difficult to move the thumb and wrist
• Pain that travels to the thumb or from the wrist and may radiate up the forearm
• Pain is worse when using the thumb and wrist, especially when making grasping or twisting movements of the wrist
• Pain or difficulty when moving the thumb, especially when pinching or grasping objects
• Snapping or popping sensations in the wrist when moving the thumb
• Numbness at the back of the thumb and index finger

Diagnosis of de Quervain’s Tendonitis

A hand surgeon specializing in treating de Quervain’s tendonitis will visually examine your hand and thumb, ask you if you know how the injury occurred, and review your reported pain and other symptoms. X-rays can help rule out other conditions. One standard test to diagnose de Quervain’s tendonitis is called the Finkelstein test. Your hand doctor will ask you to make a closed fist with your fingers over your thumb and then moving your wrist up and down, like the motion of shaking someone’s hand. If you have de Quervain’s tendonitis, you will experience significant tendon pain on the thumb-side of the wrist.

Treatment of De Quervain’s Tendonitis

Non-surgical Treatment for De Quervain's Tendonitis

The goals of treatment are to reduce pain and swelling and to maintain normal joint function. Non-surgical treatments are tried first, which may involve immobilization with a splint to keep your thumb and wrist still. Your doctor will advise you to avoid activities that cause thumb or wrist pain, and to avoid repetitive thumb and wrist movements such as typing. Over-the-counter NSAID medication can relieve pain and inflammation. If these medications prove insufficient, your doctor may recommend steroid injections into the wrist to decrease pain and swelling. Applying ice packs to the thumb area can relieve pain, as well.

Surgical Treatment for De Quervain's Tendonitis

Surgery is the next step if non-surgical treatments have proved inadequate. The goal of surgery is to eliminate pain and swelling and to restore normal range of movement to the thumb and wrist. De Quervain’s tendonitis surgery is an outpatient procedure performed under local anesthesia with mild sedation. During surgery, the tendon sheath is cut to allow more room for the tendons to slide through it. Your hand surgeon will prescribe a physical therapy program to strengthen your thumb and wrist so you can recover more quickly.

Find a surgeon that treats de Quervain’s tendonitis.
Call Newport Orthopedic Institute at
(949) 722-7038 for an appointment.

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