De Quervain Tenosynovitis

De Quervain tenosynovitis is a condition that affects the tendons on the thumb side of your wrist. It occurs when the tendons around the base of the thumb, specifically the extensor pollicis brevis (EPB) and abductor pollicis longus (APL), become inflamed.

Causes

The exact cause of De Quervain tenosynovitis is not always known, but it is often associated with:

• Repetitive movements or overuse of the thumb and wrist
• Direct injury to the wrist or thumb
• Rheumatoid arthritis or other inflammatory conditions
• Pregnancy or menopause due to hormonal changes

Symptoms

Common symptoms of De Quervain tenosynovitis include:

• Pain or tenderness on the thumb side of the wrist
• Swelling in the affected area
• Difficulty moving the thumb, especially when forming a fist or grasping objects
• A "catching" or "snapping" sensation when moving the thumb

Diagnosis

De Quervain tenosynovitis is typically diagnosed through:

• Physical examination, including the Finkelstein test, which involves bending the thumb into the palm and then bending the wrist towards the little finger to reproduce the pain
• Medical history to rule out other conditions that may be causing the symptoms
• Imaging tests such as X-rays or ultrasound to confirm the diagnosis and rule out other conditions like arthritis or a fracture

Treatment

Treatment for De Quervain tenosynovitis usually involves:

• Rest, ice, compression, and elevation (RICE) to reduce pain and inflammation
• Physical therapy to stretch and strengthen the thumb and wrist
• Wrist splints or orthotics to support the wrist and thumb
• Corticosteroid injections to reduce inflammation
• Surgery in severe cases where other treatments have not been effective, which involves releasing the tendon sheath to relieve pressure on the tendons

Prevention

To prevent De Quervain tenosynovitis, it is recommended to:

• Avoid repetitive movements or overuse of the thumb and wrist
• Take regular breaks when performing activities that involve the thumb and wrist
• Use proper technique when lifting or gripping objects
• Wear a wrist splint or orthotic to support the wrist and thumb during activities that may exacerbate the condition