de Quervain’s Tenosynovitis

What is de Quervain’s Tenosynovitis: 

De Quervain’s Tenosynovitis is a quite painful condition that causes discomfort to the thumb side of the wrist.  This happens because the two tendons that move the thumb through a pulley like system at the wrist becomes irritated.  The swelling that occurs due to this irritation limits the tendons’ ability to smoothly move back and forth through this pulley, which causes pain.  This is one of those conditions that if you use the saying, “No pain, no gain,” you will definitely get worse!   

Symptoms:

  • Pain when the thumb side of the wrist is touched, rubbed, or pain is noted when wearing a bracelet or watch.
  • Pain noted when the thumb and/or wrist is moved. 
  • Pain when pinching or lifting when gripping, especially if you are moving the wrist down and towards your small finger side. 
  • Swelling, also called edema, on the thumb side of the wrist.
  • Common in pregnant or new mothers.
  • More common in middle-aged women between 30 and 50 years old.

Causes:

  • Repetitive tasks that involve thumb/wrist motion.
  • Awkward positioning of the wrist (especially moving thumb down while moving the wrist towards the small finger side).
  • A direct blow to the thumb side of the wrist.
  • Repetitive lifting of objects/things (including a baby).
  • Hobbies like painting & carpentry, etc. 

Conservative treatment (this means treating it without surgery):

  • A thumb spica forearm based orthotic is the best way to treat this condition.  This orthotic is recommended to be worn 23 hours a day, taking it off only to perform the prescribed treatment and shower.   This orthotic MUST immobilize the thumb AND the wrist. 
  • Avoid tasks that aggravate the condition.  Any tasks that require thumb/wrist motion can make this condition worse.  Making it hurt will NOT make this diagnosis better.
  • Heat/ice depending on the stage of your injury and other modalities.  Ask your therapist which is best for your condition. 
  • Exercises:  any exercises MUST be specific to your injury.  Ask your therapist. 

Surgery:

  • Surgery is recommended only after conservative treatment has failed.  

For more information, go to https://www.assh.org/handcare/condition/dequervains-tenosynovitis

Call your doctor if you are experiencing any of these symptoms, then tell them you want to go physical therapy at Premier Physical Therapy. Let us help you find relief and avoid surgery.