De Quervain Disease / De quervain’s tenosinuvitis / Quervain’s tendinosis / de Quervain’s tendinitis

What is de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a condition that causes pain and inflammation in the tendons of your thumb. It has other names, such as de Quervain’s tendinosis or de Quervain’s tendinitis, but they all mean the same thing.

Tendons are like ropes that connect your muscles to your bones. They help you move your bones when you squeeze your muscles. Your thumb has two tendons that go through your wrist.

Normally, these two tendons can glide smoothly through a tissue tunnel called a sheath. But sometimes, the sheath around your thumb tendons can get swollen or thickened. This makes it harder for your tendons to move and creates more friction. This can make your thumb and wrist hurt and limit your movement. De Quervain’s tenosynovitis often causes pain at the base of your thumb that can spread to your forearm.

How common is de Quervain’s tenosynovitis?

It is one of the most common type of tenosynovitis.

What are the sign symptom of de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis causes pain in the wrist on the thumb side (the radial side). The pain can start suddenly or gradually. It usually increases when you use your hand, wrist and thumb. Pain may spread from your wrist to your thumb or forearm. Worsens when you hold or squeeze things. You may also have: 1. swelling 2. a cracking or clicking sound in your wrist when you move your thumb. 3. reduced smoothness or flexibility of your thumb 4. Loss of feeling in your wrist or thumb.

What are the causes of de Quervain’s tenosynovitis?

Some of the most common reasons for this are:

• Using your thumb or wrist too much.

• Holding or squeezing things over and over for work or a hobby.

• Health problems (example: arthritis) that make your body prone to inflammation.

• Getting hit on your thumb or wrist.

• Doing things that make you move your thumb and wrist a lot while holding something firmly can also cause De Quervain’s tenosynovitis, such as: longtime holding a baby in arms, racquet sports, gardening etc.

Who are at risk of developing De Quervain’s tenosynovitis?

De Quervain’s tenosynovitis can affect anyone, but some people have a higher chance of getting it, such as: 1. Female gender 2. people in their 40s or older.

How to diagnose De Quervain Disease?

A Pain Physician must physically examine the thumb by looking at it and touching it. He will see if it is swollen or sore. Then, your doctor may do some tests such as Finkelstein test. For this test, you will fold your thumb over your palm and close your fingers around it. Then, you will tilt your wrist towards your pinky finger. If this test hurts, you are most likely to have De Quervain disease.

What are the treatments of De Quervain Disease?

General recommendations

1. OTC Painkillers will help with the pain and swelling.

2. A splint to keep the thumb and wrist still. You may have to wear it for two to six weeks.

3. You may use ice compress on the thumb and wrist area.

4. Stay away from thumb movements that you do over and over.

5. Don’t pinch or hold things tightly.

6. Exercises to make your thumb and wrist move better. You may also have to go to a physical therapist for the right kind of exercises.

What are the Pain intervention options?

Peritendinous injection of steroid: A very small amount of steroid injection around the tendon under ultrasound can make the swelling and pain go down.

Regenerative therapy: Sometimes the tendon is damaged and worn out. That is why, putting growth factors inside the tendon heals the tendon permanently, but this is a slow process.

Surgical option: Non-surgical interventions work in most patients. But if it recurs again and again, pain specialist will refer the patient for surgery. Surgery relieves your tendons of their sheath so that they can move smoothly.

You can always contact Dr Chinmoy Roy at Rajarhat pain clinic at Newtown, Kolkata for best treatment of .De Quervain Disease