hands

As expert hand and wrist surgeons in Jacksonville, FL, we treat a multitude of conditions, including De Quervain’s tenosynovitis. This painful condition, which affects the tendons on the thumb side of the wrist, can significantly impair hand functionality and cause considerable discomfort. By providing our patients with a deep understanding of the causes, risk factors, and symptoms of De Quervain’s tenosynovitis, we help them make informed choices about their hand and wrist health, ultimately leading to improved hand function and reduced pain.

De Quervain’s tenosynovitis occurs when the tendons around the base of the thumb become inflamed and swollen, resulting in pain and restricted thumb movement. This inflammation may be due to repetitive or forceful hand and wrist motions or may arise as a consequence of pregnancy or specific medical conditions, such as rheumatoid arthritis. With the increasing prevalence of smartphone usage, De Quervain’s tenosynovitis has garnered more attention due to its association with “texting thumb” or repetitive thumb movements during smartphone use.

Unraveling the Causes and Risk Factors of De Quervain’s Tenosynovitis

Gaining insight into the possible causes and risk factors of De Quervain’s tenosynovitis is crucial for preventative measures and effective management of the condition:

  1. Causes: While the exact cause of De Quervain’s tenosynovitis is not fully understood, repetitive hand and wrist movements, forceful gripping, and a genetic predisposition to inflammation are believed to contribute to the condition.
  2. Risk factors: Certain factors can increase an individual’s likelihood of developing De Quervain’s tenosynovitis, such as being female, between the ages of 30 and 50, pregnant or postpartum, and dealing with medical conditions like rheumatoid arthritis or diabetes. Additionally, activities that involve repetitive wrist and thumb motions, such as playing sports or using smartphones excessively, can contribute to the onset of the condition.

Identifying the Symptoms of De Quervain’s Tenosynovitis

Recognizing the symptoms of De Quervain’s tenosynovitis permits patients to seek timely medical intervention, facilitating a more effective recovery:

  1. Pain and swelling: Patients may experience pain near the base of the thumb, which can extend along the thumb side of the forearm. Swelling and inflammation around the thumb and wrist are also common symptoms.
  2. Difficulty in movement: De Quervain’s tenosynovitis may restrict thumb and wrist motion, leading to a reduced range of movement or triggering a “catching” sensation when attempting to move the thumb.
  3. Pain with resistance: The condition often presents as pain when attempting to clench the hand, grasp objects, or move the thumb against resistance.

Diagnosing De Quervain’s Tenosynovitis

Proper diagnosis involves a comprehensive physical examination and assessment of the patient’s medical history:

  1. Physical examination: Our experienced practitioners will evaluate the patient’s hand and wrist, taking note of any swelling or tenderness around the base of the thumb. We may perform the Finkelstein test, where the patient makes a fist with the thumb inside and bends the wrist toward the little finger, which can exacerbate the pain in the presence of De Quervain’s tenosynovitis.
  2. Medical history: A thorough review of the patient’s medical history will provide valuable information about possible causes, risk factors, and any pre-existing conditions contributing to the issue.

Non-Surgical Treatment Options for De Quervain’s Tenosynovitis

Conservative treatment approaches can often effectively manage De Quervain’s tenosynovitis, alleviating symptoms and restoring hand mobility:

  1. Activity modification: Patients may be advised to avoid or limit activities that involve repetitive wrist and thumb motions, as well as reduce any forceful grips or hand motions.
  2. Splinting and immobilization: Wearing a thumb spica splint to immobilize the thumb and wrist may significantly alleviate pain and promote healing.
  3. Anti-inflammatory medication: Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) or prescription anti-inflammatory medication may help reduce inflammation and pain.
  4. Corticosteroid injections: An injection of corticosteroids into the tendon sheath can provide rapid and long-lasting relief from inflammation and pain.

Surgical Treatment Options for De Quervain’s Tenosynovitis

If conservative treatments are unsuccessful in alleviating symptoms, surgery might be considered:

  1. Surgical release: This procedure involves making a small incision near the base of the thumb to open the tendon sheath, relieving pressure on the tendons and allowing them to glide smoothly. The surgery can be performed on an outpatient basis with local anesthesia.
  2. Recovery and rehabilitation: Post-surgery, patients may wear a splint or bandage temporarily to support the area while it heals. Gentle hand exercises to improve range of motion, strength, and flexibility are usually recommended once the splint is removed.

Importance of Early Intervention and Hand Therapy

Early intervention for De Quervain’s tenosynovitis is critical to maximize treatment effectiveness and improve patients’ quality of life. Hand therapy, involving exercises, stretches, and occupational therapy, can aid in regaining full hand functionality and minimizing the chances of recurrence.

Conclusion

De Quervain’s tenosynovitis is a painful hand condition that can cause significant discomfort and limit thumb and wrist movement. Understanding the causes, risk factors, and symptoms of this condition facilitates early intervention and maximizes the potential for successful treatment. 

If you suspect you may be experiencing De Quervain’s tenosynovitis or are struggling with hand or wrist pain, reach out to our skilled Jacksonville, FL team for a comprehensive evaluation and tailored treatment plan. Contact our orthopedic wrist specialist today to schedule your appointment!