WHAT IS DE QUERVAIN’S TENOSYNOVITIS?
Tenosynovitis is an inflammation of the soft issues that surround tendons called synovium. De Quervain’s tenosynovitis, is a condition where this inflammation occurs around the tendons on the thumb side of the wrist. We very commonly see this in women with newborns or very young children, hence the nickname "Mommy Wrist". The position of the hand and wrist when lifting a baby puts extra stress on the tendons that cross the thumb side of the wrist, and over time some mothers will develop inflammation where those tendons travel through a tight wrist compartment. This condition can occur in anyone and is not always related to lifting activities.
CAUSES
· Swelling due to pregnancy, or repetitive lifting of newborns
· Overuse or repetitive activities of the thumb/wrist
· Work or sports injuries
· Inflammatory diseases (rheumatoid, gout)
· Direct injury to the wrist tendons
SIGNS AND SYMPTOMS
Symptoms of this condition can include:
· Pain with use of the thumb/hand/wrist, sometimes both wrists
· Pain worse when placing the thumb inside a closed fist and bending the wrist sideways in the direction away from the thumb (Finkelstein’s maneuver)
· Tenderness localizing to the boney “bump” on the thumb side of the wrist
· Clicking, popping, swelling over the thumb side of the wrist.
IS THERE A TEST FOR DE QUERVAIN’S?
Most cases of De Quervain’s tenosynovitis can be diagnosed easily on physical exam. Sometimes and X-ray or MRI will be ordered to rule out other potential sources of pain.
TREATMENT
I typically start with nonoperative treatment options including:
· Activity modification recommendations
· Splinting
· Anti-inflammatory medications
· Steroid injections
Operative Treatment:
In cases that are severe, long-standing, or have failed nonoperative treatment, a minor surgical procedure can often significantly improve symptoms. There are several options regarding the type of anesthesia and procedure, but the most common technique involves mild IV sedation, local numbing at the site of pain, then a small incision around the affected tendon to relieve pressure on the tendon and remove any inflamed tissue. Some people choose to have the procedure done with just local numbing and no sedation in the office.
READY TO CONFIRM A DIAGNOSIS AND FIX THE PROBLEM OR JUST WANT TO LEARN MORE?
I am here to help! I can often diagnose the problem in one visit, and get you started with a treatment plan. I offer a wide variety of both nonoperative and operative treatment options.
Call Hand Institute of Charleston today for a clinic or telehealth appointment! 854-423-4263
This article is not a substitute for in-person medical advice or diagnosis and is for educational purposes only.
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