What is De Quervain’s Syndrome ?

De Quervain’s Syndrome is the medical term for what is commonly referred to as Gamer’s Thumb or Text Thumb. De Quervain’s Syndrome, or De Quervain’s Tenosynovitis, is a painful condition that causes pain located at the base of the thumb over the wrist. In De Quervain’s Syndrome, the tendons of the thumb become irritated and inflamed, usually as a result of overuse, such as in excessive gaming or texting. The tendons that connect the muscles responsible for movement of the thumb are connected to the bones of the thumb. These tendons run through a tendon sheath. This sheath is a band of connective tissue that securely attaches these tendons close to the hand and normally allows for a smooth, gliding motion of the tendons. When either this sheath or the tendons themselves become irritated, they will thicken and loss of smooth motion will occur as well as significant pain.

What Causes De Quervain’s Syndrome?

Any activity that requires excessive use of the thumb can lead to De Quervain’s Syndrome. This is why it will often be referred to as Gamer’s Thumb or Text Thumb. Some causes and risk factors include:

● Overuse of the thumb involving repetitive motions commonly associated with activities such as gaming, texting, gardening, playing golf, lifting a child, tennis, or skiing, playing a musical instrument
● Pregnancy and other conditions that affect hormones
● Rheumatoid arthritis
● Previous traumatic injury to the wrist leading to a build-up of scar tissue
● A direct blow to the thumb
● Age (more common in patients over the age of 40)
● More common to occur in women than men

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What are the Symptoms of De Quervain’s Syndrome?

Symptoms of De Quervain’s Syndrome may include one or all of the following and may worsen over time:

● Significant pain located at the base of the thumb over the wrist and may extend up the forearm
● Swelling of the wrist
● Snapping or catching sensation with movement of the thumb
● Exacerbation of pain with gripping and grasping motions

Treatment for De Quervain’s Syndrome

The treatment for this condition will depend on how far it has progressed and how much pain and dysfunction it is causing. The treatment options are:

● Discontinuation of aggravating activities
● NSAIDs (non-steroidal anti-inflammatory drugs)
● Splinting or bracing
● Cortisone injections
● Treatment with a physical or occupational therapist, preferably one that is a Certified Hand Therapist

Often surgery will not be needed and avoidance of aggravating activities and learning to place less stress on the tendons of the thumb will be successful. However, if attempted, and the conservative treatment methods listed above fail to reduce pain and improve function an adequate amount, surgical intervention may be considered. The surgery for this condition is a simple outpatient procedure in which your doctor will make a small cut in the tendon sheath in order to allow for smoother, freer motion of the tendons of the thumb. A course of physical or occupational therapy will be required after surgery in order to restore strength, range of motion, and function.
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