De Quervain’s tenosynovitis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain’s tenosynovitis, it will probably hurt when you turn your wrist, grasp anything or make a fist.
Although the exact cause of de Quervain’s tenosynovitis isn’t known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports, or lifting your baby — can make it worse.
Symptoms of de Quervain’s tenosynovitis include:
- Pain near the base of your thumb
- Swelling near the base of your thumb
- Difficulty moving your thumb and wrist when you’re doing something that involves grasping or pinching
- A “sticking” or “stop-and-go” sensation in your thumb when moving it
If the condition goes too long without treatment, the pain may spread further into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.
When to see a doctor
Consult your doctor if you’re still having problems with pain or function and you’ve already tried:
- Not using your affected thumb
- Applying cold to the affected area
- Using nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
Chronic overuse of your wrist is commonly associated with de Quervain’s tenosynovitis.
Tendons are rope-like structures that attach muscle to bone. When you grip, grasp, clench, pinch or wring anything in your hand, two tendons in your wrist and lower thumb normally glide smoothly through the small tunnel that connects them to the base of the thumb. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement.
Other causes of de Quervain’s tenosynovitis include:
- Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons
- Inflammatory arthritis, such as rheumatoid arthritis
Risk factors for de Quervain’s tenosynovitis include:
- Age. If you’re between the ages of 30 and 50, you have a higher risk of developing de Quervain’s tenosynovitis than do other age groups, including children.
- Sex. The condition is more common in women.
- Being pregnant. The condition may be associated with pregnancy.
- Baby care. Lifting your child repeatedly involves using your thumbs as leverage and may also be associated with the condition.
- Jobs or hobbies that involve repetitive hand and wrist motions. These may contribute to de Quervain’s tenosynovitis.
Untreated de Quervain’s tenosynovitis might make it hard to use your hand and wrist properly and limit your wrist’s range of motion.
Treatment for de Quervain’s tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence.
If you start treatment early, your symptoms should improve within four to six weeks. If your de Quervain’s tenosynovitis starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breast-feeding.
Initial treatment of de Quervain’s tenosynovitis may include:
- Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
- Avoiding repetitive thumb movements as much as possible
- Avoiding pinching with your thumb when moving your wrist from side to side
- Applying ice to the affected area
The Physiotherapist may review how you use your wrist and give suggestions on how to make adjustments to relieve stress on your wrists. The Physiotherapist can also teach you exercises for your wrist, hand and arm to strengthen your muscles, reduce pain and limit tendon irritation.
Lifestyle and home remedies
After the treatment, caring for your condition is much the same as preventing it:
- Avoid moving your wrists the same way repeatedly.
- Wear a brace or splint if suggested by your doctor.
- Follow through with recommended exercises.
- Note activity that causes pain, swelling or numbness in your thumb and wrist, try to avoid it, and share that information with your doctor.