De Quervain’s tenosynovitis is a painful hand and wrist condition characterized by inflammation of the tendons on the thumb side of the wrist. Also known as “washerwoman’s sprain” or “texting thumb,” this condition occurs when the two tendons responsible for moving the thumb become swollen and constricted by their tendon sheath, leading to pain and restricted mobility. De Quervain’s tenosynovitis can impact daily activities, making it essential for patients to effectively address and manage its symptoms through appropriate treatment approaches.

At North Florida Hand and Wrist, our team of highly-skilled hand and wrist surgeons, led by Dr. Richard D. Curtis and Dr. Jose Baez, is committed to providing the highest quality care for patients affected by De Quervain’s tenosynovitis. Our state-of-the-art facility, staffed by a team of dedicated practitioners, focuses on alleviating discomfort associated with this condition and restoring full function and mobility to the hand and wrist.

In this comprehensive guide, we will delve into the causes and risk factors for De Quervain’s tenosynovitis, discuss how to identify its signs and symptoms, examine methods of diagnosis, and explore the range of non-surgical and surgical treatments available at North Florida Hand and Wrist. By understanding the underlying causes and accessing the most appropriate treatment options for De Quervain’s tenosynovitis, patients can make informed decisions regarding their hand and wrist health and enjoy a pain-free life.

Causes and Risk Factors of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis occurs when the tendons of the first dorsal compartment of the wrist, responsible for moving the thumb, become inflamed. Several factors can contribute to this inflammation and increase the risk of developing De Quervain’s tenosynovitis:

  1. Repetitive thumb and wrist motions: Engaging in activities that involve repetitive or forceful thumb and wrist movements, such as typing, knitting, gardening, or playing sports, can contribute to the development of De Quervain’s tenosynovitis.
  2. Occupational factors: Occupations that require frequent or forceful thumb and wrist movements or involve prolonged periods of gripping objects can increase the risk for developing this condition.
  3. Hormonal changes: Hormonal fluctuations during pregnancy or postpartum can lead to fluid retention and swelling in the wrist, contributing to tendon inflammation.
  4. Medical conditions: Rheumatoid arthritis, diabetes, and other inflammatory conditions may predispose individuals to De Quervain’s tenosynovitis.

Identifying Symptoms of De Quervain’s Tenosynovitis

The primary symptoms of De Quervain’s tenosynovitis include pain and stiffness in the thumb and wrist. Common indications that you may have this condition are:

  1. Pain and swelling: Pain, often accompanied by swelling, is typically experienced over the thumb side of the wrist. This pain may worsen when using the thumb and wrist or attempting to grip objects.
  2. Stiffness: Restriction in thumb and wrist movement may be experienced, with difficulty performing activities such as pinching or grasping.
  3. “Sticking” sensation: The tendons affected by De Quervain’s tenosynovitis may sometimes feel like they are “sticking” or “catching” during movement.
  4. Radial wrist pain: Pain can radiate up the forearm when moving the thumb or wrist, making it difficult to perform daily activities.

Diagnosis of De Quervain’s Tenosynovitis

A thorough physical examination, combined with an assessment of your medical history, is paramount for diagnosing De Quervain’s tenosynovitis accurately. Your healthcare provider will assess the affected thumb and wrist, noting any swelling, tenderness, or range-of-motion limitations. They may also perform Finkelstein’s test, which involves making a fist with your thumb inside and bending the wrist toward the little finger; this movement may elicit pain in those with De Quervain’s tenosynovitis. In most cases, additional imaging tests such as x-rays or MRI are not required to confirm the diagnosis.

Non-Surgical Treatment Options for De Quervain’s Tenosynovitis

Initial treatment for De Quervain’s tenosynovitis typically involves non-surgical interventions:

  1. Rest and activity modification: Refraining from activities that cause pain or involve repetitive thumb and wrist movements can provide relief and promote healing.
  2. Immobilization: Wearing a splint or brace on the affected wrist and thumb can help reduce inflammation, as it limits movement and promotes proper positioning.
  3. Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation.
  4. Heat or cold therapy: Applying heat or cold packs to the affected area may offer temporary pain relief.
  5. Corticosteroid injections: If conservative treatments do not provide adequate relief, corticosteroid injections delivered directly into the tendon sheath may be recommended to reduce inflammation and alleviate pain.

Surgical Treatment Options for De Quervain’s Tenosynovitis

When non-surgical treatments fail to provide symptom relief or if the condition is severe, surgical intervention may be considered. The surgery, known as De Quervain’s release, involves making a small incision near the base of the thumb to open the tendon sheath and release the pinched tendons. This procedure can be performed under local anesthesia on an outpatient basis.

Recovery from De Quervain’s release usually involves wearing a splint or cast for a few weeks, followed by physical therapy to regain strength and mobility in the hand and wrist. Most patients can return to their normal activities within six to eight weeks following surgery.

Conclusion

De Quervain’s tenosynovitis can significantly affect daily tasks and limit hand function. At North Florida Hand and Wrist, our highly skilled team, led by Dr. Richard D. Curtis and Dr. Jose Baez, offers comprehensive care and a range of treatment options to help alleviate pain and restore hand function. Contact us today to schedule an evaluation with a wrist doctor.