Dr BurkeWhat Is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. This condition is caused by inflammation of the tendons in the wrist, which can make it difficult to perform everyday activities such as grasping, pinching, or lifting objects. At Dr. Burke Orthopedics, we provide specialized care for patients with De Quervain’s Tenosynovitis, offering both conservative treatments and surgical options to relieve pain and restore function.
De Quervain’s Tenosynovitis occurs when the two tendons that run along the thumb side of the wrist become irritated and inflamed. These tendons, the abductor pollicis longus and extensor pollicis brevis, are responsible for controlling thumb movement. The inflammation causes the tendons to swell and thicken, which restricts their movement through a small tunnel or sheath in the wrist, leading to pain and discomfort.
This condition is common in individuals who engage in repetitive hand or wrist movements, such as new mothers lifting their babies, manual laborers, or individuals who use their smartphones frequently.
Causes of De Quervain’s Tenosynovitis
The exact cause of De Quervain’s Tenosynovitis is often linked to repetitive hand and wrist motions that can irritate the tendons. Common causes include:
- Repetitive Hand Movements: Activities that involve repetitive grasping, pinching, or lifting motions can put strain on the tendons in the wrist, leading to inflammation. This is common among individuals who frequently lift heavy objects, new mothers who carry their babies, or those who engage in sports like tennis or golf.
- Overuse of the Wrist: Overuse of the wrist, particularly from repetitive motions such as texting, typing, or working with tools, can cause irritation and inflammation of the tendons.
- Direct Injury: A sudden injury to the wrist or thumb, such as a fall or strain, can trigger the onset of De Quervain’s Tenosynovitis.
- Inflammatory Conditions: Conditions such as rheumatoid arthritis can cause inflammation in the joints and tendons, contributing to the development of this condition.
While De Quervain’s Tenosynovitis can affect anyone, it is most common in individuals between the ages of 30 and 50 and is more prevalent in women, especially during pregnancy or postpartum due to frequent lifting of infants.
Symptoms of De Quervain’s Tenosynovitis
The symptoms of De Quervain’s Tenosynovitis can develop gradually or appear suddenly. The most common signs include:
- Pain and Tenderness: Pain on the thumb side of the wrist is the most prominent symptom. The pain may radiate up the forearm or down into the thumb, and it often worsens with wrist or thumb movement.
- Swelling: Swelling around the base of the thumb or on the thumb side of the wrist may be present, making it difficult to move the thumb and wrist.
- Difficulty Grasping or Pinching: Everyday tasks like grasping, pinching, or lifting objects can become painful or difficult due to the limited movement of the thumb.
- Stiffness and Weakness: Stiffness in the wrist and thumb, as well as a weakened grip strength, may develop as the condition progresses.
- Creaking Sensation: Some patients may experience a "creaking" or snapping sensation when moving the thumb, caused by the inflamed tendons moving through the sheath.
Diagnosis of De Quervain’s Tenosynovitis
At Dr. Burke Orthopedics, diagnosing De Quervain’s Tenosynovitis begins with a thorough physical examination and a discussion of the patient’s symptoms and activity history. Key diagnostic steps include:
1. Physical Examination: The doctor will examine the wrist and thumb for swelling, tenderness, and pain during movement. Specific movements, such as gripping or rotating the wrist, may help confirm the diagnosis.
2. Finkelstein Test: This test is commonly used to diagnose De Quervain’s Tenosynovitis. The patient is asked to make a fist with their thumb tucked inside the fingers and then bend the wrist toward the little finger. If this movement causes pain on the thumb side of the wrist, it is likely that De Quervain’s Tenosynovitis is present.
3. Imaging Tests: In most cases, imaging tests like X-rays or MRIs are not necessary for diagnosing De Quervain’s Tenosynovitis. However, they may be used to rule out other conditions, such as arthritis or fractures, if the diagnosis is unclear.
Treatment for De Quervain’s Tenosynovitis
Treatment for De Quervain’s Tenosynovitis at Dr. Burke Orthopedics focuses on reducing pain and inflammation while restoring normal function in the wrist and thumb. Conservative treatments are typically effective, but surgery may be recommended in more severe cases.
1. Non-Surgical Treatments:
- Rest and Activity Modification: Avoiding activities that aggravate the condition, such as repetitive gripping or lifting, is crucial for allowing the tendons to heal. Resting the wrist and thumb and temporarily reducing physical activity can help reduce inflammation.
- Bracing or Splinting: Wearing a brace or splint that immobilizes the thumb and wrist can help reduce movement and alleviate pressure on the tendons, allowing them to heal more effectively.
- Ice and Compression: Applying ice to the affected area and using compression can help reduce swelling and inflammation.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help relieve pain and reduce inflammation in the tendons.
- Corticosteroid Injections: For more severe cases, corticosteroid injections may be administered directly into the tendon sheath to reduce inflammation and provide long-term relief from pain.
2. Surgical Treatments: If conservative treatments do not provide relief after several months, surgery may be recommended to relieve the pressure on the tendons. The procedure involves:
- Tendon Release Surgery: During this procedure, the surgeon makes a small incision in the tendon sheath to release the pressure on the inflamed tendons, allowing them to move freely without irritation. The surgery is usually performed on an outpatient basis, and patients can expect to regain full function of the wrist and thumb with proper post-surgical care.
Recovery and Rehabilitation
Recovery from De Quervain’s Tenosynovitis depends on the severity of the condition and the type of treatment received. Most patients experience significant improvement with non-surgical treatments within a few weeks to a few months.
- Non-Surgical Recovery: For patients undergoing conservative treatment, the pain and inflammation often resolve within a few weeks. Patients may gradually return to their normal activities as the symptoms improve, but it’s important to avoid overuse or repetitive motions that could cause a recurrence.
- Post-Surgical Recovery: For patients who undergo surgery, recovery times are typically short, with most patients returning to normal activities within 4-6 weeks. A physical therapy program may be recommended to help strengthen the wrist and thumb, restore flexibility, and prevent future flare-ups.
Dr. Burke Orthopedics offers personalized rehabilitation plans tailored to each patient’s needs, ensuring a smooth recovery and minimizing the risk of recurrence.
Why Choose Dr. Burke Orthopedics for De Quervain’s Tenosynovitis?
At Dr. Burke Orthopedics, we understand how disruptive De Quervain’s Tenosynovitis can be to daily activities. Our team of orthopedic specialists is committed to providing personalized, compassionate care using the latest techniques in both conservative and surgical treatment options. With a focus on relieving pain, restoring function, and preventing recurrence, Dr. Burke Orthopedics ensures that patients receive the highest level of care and support throughout their recovery.