What is De Quervains tenosynovitis?

Tendons are the tough bands of tissue that connect your muscles to your bone. When your muscles contract, they pull on the tendons, which control your bones and allows you to move. Some tendons are encased by a sheath that protects them.

Tendonitis is an inflammation of the tendons, the tough tissue that connects your muscles to your bones. Tenosynovitis is tendonitis where both the tendon and the sheath have been inflamed.

De Quervain’s tenosynovitis is a condition where the tendons and tendon sheath in your wrist near your thumb get inflamed. 

De Quervain’s tenosynovitis is most commonly caused by straining the thumb or wrist. This may happen in repetitive tasks like typing, certain sports, or repeated lifting. Some groups are more at risk for this condition than others:

  • People between the ages of 30 and 50.
  • Women, especially those who are pregnant.
  • People who care for children, because lifting babies or children repeatedly can strain the wrist.
  • Gardeners, athletes, and people who work at a computer, because their thumbs and wrists can be under more pressure.

Symptoms

Symptoms of de Quervain’s tenosynovitis are similar to those of other kinds of tendonitis that you can get in your wrist, elbow, heels, or other parts of your body. Common symptoms include:

  • Pain. You might feel pain near the base of your thumb or on the thumb side of your wrist. The pain might also move up your forearm. The pain can be worse when you are using your hand and thumb, especially if you’re twisting your wrist or gripping something.
  • Swelling. You may see or feel swelling near the base of your thumb where it connects to the tendons in your wrist.
  • Limited movement. If you have De Quervain’s tenosynovitis, you might not be able to move your thumb and wrist very far.
  • Snapping or catching. When you move your thumb, you might feel or hear a catching or snapping sound, which happens because the tendon can’t keep the thumb in place.

When to See a Doctor

Sometimes, de Quervain’s tenosynovitis can get better over time, especially if you take steps and avoid using your thumb, wrist, and hand while the injury heals. If your symptoms don’t get better after a couple of weeks, you should see a healthcare provider as soon as possible so they can do an exam, look for other problems, and suggest treatments to help you get better.

Causes

The symptoms of de Quervain’s tenosynovitis are caused by inflammation of the tendons or the tendon sheath in the thumb and wrist.

Tendons can get inflamed for a few reasons:

Arthritis

Osteoarthritis and rheumatoid arthritis cause damage to the joints and tendons, which weakens them and makes them easier to injure.

Injury

You might get de Quervain’s tenosynovitis if you have injured your wrist, like in an accident. Injuries leave scar tissue behind, and this scar tissue can make it hard to move your tendons, which puts more strain on them when you use them a lot.

Overuse

This is the most common cause of de Quervain’s tenosynovitis. Repetitive movements can cause irritation in the tissue. Sometimes, this can heal on its own without you noticing, but if you use the same motions too much for a long period of time, your body can’t heal and the tears get worse.

Diagnosis and Tests

If your healthcare provider thinks that you have de Quervain’s tenosynovitis, they will ask you some questions and do a physical exam to confirm you have this condition. Some of the questions your healthcare provider might ask you include:

  • When did your symptoms start?
  • Is there anything that makes your symptoms worse?
  • Are your symptoms getting worse, staying the same, or getting better?
  • What other treatments have you tried so far?

During the physical exam, your healthcare provider will look at and press on the part of your hand that is giving you problems.

Usually, imaging tests like x-rays are not needed to diagnose this condition. Instead, your healthcare provider might do a Finkelstein test. During this test, your healthcare provider will ask you to:

  • Bend your thumb across your palm.
  • Bend your fingers over your thumb.
  • Bend your wrist toward your little finger.

If doing this causes pain on the thumb side of your wrist, your healthcare provider might be able to diagnose de Quervain’s tenosynovitis.

Treatments

Treatment for de Quervain’s tenosynovitis is focused on relieving your pain and letting your thumb and wrist rest so they have time to heal. Some of the treatments your healthcare provider might use include:
  • Avoiding activities that cause pain.
  • Heat or ice on the affected area.
  • Splint. A splint is a sheath made out of tough fabric or other material that keeps your thumb and wrist from moving so they can heal faster.
  • Anti-inflammatory medicines. These medicines can help relieve pain and reduce swelling in your tendons in the tendon sheath. Examples include ibuprofen (Advil, Motrin) and naproxen (Aleve).
  • Corticosteroids. Your healthcare provider might inject corticosteroids into the tendon sheath to help you heal faster and reduce swelling and pain.
  • Therapy. A physical therapist or occupational therapist can teach you to use your hand and wrist in ways that reduce stress.
  • Surgery. Surgery is an option if other care fails.

Most people notice improvement within 4 to 6 weeks of treatment.

Prevention

The best way to prevent de Quervain’s tenosynovitis is to avoid repetitive movements that put pressure on your thumb and your wrist. Some steps you can take include:

  • Take breaks. Taking breaks from things like gardening, typing, and lifting children when you can. This will give your thumb and wrist time to rest before you have to use the more.
  • Use proper technique. Lifting, typing, and moving in the right way can reduce the pressure on your wrist and stop your tendons from being strained or damaged.