De Quervain's Tenosynovitis

De Quervain's Tenosynovitis is a condition in which a patient feels pain over the wrist joint near the base of the thumb. The tendons that extend and abduct the thumb are involved and become constricted in a tight tunnel that becomes progressively inflamed from friction and repetitive tendon gliding.

The cause of De Quervain’s Tenosynovitis has not been established. However, the inflammation of the tendons has been linked to repetitive trauma or overuse of the thumb and wrist in daily activities such as:

• The wrist held in an awkward position while pinching or peeling.
• Resistive thumb motion performed repeatedly.
• Repetitive twisting of the wrist, together with prolonged gripping (e.g. wringing towels, and scrubbing surfaces).
• Direct injury to the wrist or tendon which causes tissue scarring.

Most patients experience pain at the side of the wrist, near the base of the thumb. It usually occurs after recent increased activity involving the wrist and hand. It begins as an aching sensation initially and progresses to a point when any movement of the wrist or thumb produces sharp pain in the affected area. That area of the wrist may become swollen at times. Some may experience difficulty with activities that involve pinching, lifting the thumb or turning the wrist (e.g. wringing towel, cutting with scissors, stapling).

Doctors will first try non-surgical methods of treatment, such as making you wear a splint, prescribing anti-inflammatory medication orally, or by giving you an injection of steroids.

When symptoms persist without improvement, surgery may be recommended. The procedure is minor and is performed as a day surgery case.

Surgery is almost always successful and you will regain normal use of your hand upon recovery.

Occasionally, you may require hand therapy after your surgery to regain normal function of your hand.