Wrist and Hand related pages:

De Quervain’s tenosynovitis

– irritation of the thumb tendons. 

De Quervian’s is an irritation of the Abductor Pollicus Longus (APL) and Extensor Pollicus Brevis (EPB) tendons of the thumb that share a protective sheath surrounding them.  These tendons are located on the radial (thumb side) of the wrist and are often the cause of pain into the thumb and wrist. 

De Quervain’s tenosynovitis

De Quervain’s tenosynovitis

 

What is the cause? 

De Quervain’s is caused by repetitive movements of the wrist and thumb normally from work or sporting activities but can occasionally be caused by an injury. 

 

Who it affects? 

It mainly affects:  

  • women more than men. 
  • People between the ages of 30-50. 
  • Is very common in women after having a baby. 

 Symptoms 

  • Pain along the thumb and the radial side of the wrist. 
  • Pain on moving the thumb and certain movements of the wrist. 
  • Pain with activities like opening jars, picking things up with a wide grip, picking children up and wringing cloths out. 
  • Very occasionally mild swelling to the radial side of the wrist. 

 Treatment 

  • Rest – resting from aggravating activity where possible. 
  • Ice (if swollen) – resting a small bag of ice or frozen peas wrapped in a cloth over the affected area. 
  • NSAIDS – non steroidal anti-inflammatory medication may be beneficial in managing pain.  This should be discussed with your GP or Pharmacist to ensure you are able to take the medication. 
  • Splint – Short term use of a thumb splint may be beneficial to some people.  The splint should not be worn all of time and should be removed frequently to exercise the hand. 
  • Exercises –You may be given exercises by a Physiotherapist. 

 

The condition is self-limiting so will normally resolve with rest and activity modification.  Very occasionally symptoms will be persistent and may require a steroid injection.  This would only be discussed with your clinician and offered after approximately 6 weeks of using the splint and modifying your activity.  Repeated injections however should be avoided as can cause changes to the skin and long term problems with the tendon itself.