De Quervain’s Tenosynovitis

– irritation of the thumb tendons. 

De Quervian’s tenosynovitis is an irritation of the tendons and their covering sheath that control the thumb, specifically the Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB) tendons. These tendons are located on the radial (thumb side) of the wrist and are often cause pain into the thumb and wrist when gripping, carrying or lifting activities.

De Quervain’s tenosynovitis

De Quervain’s tenosynovitis


What is the cause?

De Quervain’s is caused by repetitive activities and movements of the wrist and thumb normally from work or sporting activities, or actions such as repeated lifting and carrying such as holding a baby. The condition can also occasionally present as a result of 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 and will normally resolve with rest, activity modification and time.  Occasionally a steroid injection may be considered for the condition if pain persists and is not improving with the above noted measures. Steroid injections are often not a first line treatment, nor are repeated injections, as they can cause damage to the skin and tendon structures.