Understanding De Quervain's Tenosynovitis: Causes, Symptoms, and Treatment Options

De Quervain's Tenosynovitis is a painful condition that affects the tendons in the wrist and lower thumb. This disorder can disrupt daily activities and cause significant discomfort. In this blog post, we’ll take a deeper dive into what De Quervain's Tenosynovitis is, its symptoms, causes, and how it can be treated effectively.

What is De Quervain's Tenosynovitis?

De Quervain's Tenosynovitis is an inflammation of the tendons located at the base of the thumb, particularly the tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB). These tendons help with the movement of the thumb and wrist. When these tendons become inflamed, the tendons’ sheaths — the protective coverings around them — thicken and cause pain.

The condition is often linked to overuse or repetitive motion of the wrist, especially activities that involve gripping, pinching, or twisting motions. De Quervain’s is relatively common among individuals who perform repetitive tasks, such as in office work, sports, or manual labor.

Symptoms of De Quervain's Tenosynovitis

The symptoms of De Quervain’s can vary from person to person, but common signs include:

1. Pain at the Base of the Thumb: Pain usually starts near the base of the thumb and can radiate to the wrist or forearm. The pain may worsen with certain activities such as grasping objects or turning the wrist.

2. Swelling: Swelling around the thumb or wrist area may become noticeable, especially after prolonged use or activity.

3. Tenderness: The affected area is often tender to the touch, especially when pressure is applied to the base of the thumb.

4. Limited Range of Motion: Moving the thumb or wrist may become more difficult and painful, making it challenging to perform tasks that involve gripping or turning motions

Causes of De Quervain's Tenosynovitis

De Quervain's is often caused by repetitive motion or overuse, but several factors can contribute to its development:

1. Repetitive Motion: Engaging in activities that require repetitive wrist and thumb movements, such as typing, texting, knitting, or playing certain sports (e.g., golf, tennis), can strain the tendons and lead to inflammation.

2. Pregnancy and Hormonal Changes: Pregnant women, particularly during their third trimester, may experience a higher risk of developing De Quervain’s. Hormonal changes and fluid retention can contribute to the condition.

3. Age: The condition is most common in individuals between the ages of 30 and 50, though it can affect anyone.

4. Injury: A direct injury to the wrist or thumb, such as a sprain or fracture, can damage the tendons, making them more prone to inflammation.

5. Health Conditions: Conditions like rheumatoid arthritis or diabetes may increase the risk of developing De Quervain’s due to their effects on tendon health and inflammation.

Treatment for De Quervain's Tenosynovitis

The good news is that De Quervain's Tenosynovitis is often treatable with conservative methods. Depending on the severity of the condition, several treatment options are available:

1. Rest and Activity Modification: Giving the wrist and thumb time to heal by avoiding repetitive motions and heavy gripping is essential. If the condition is linked to a specific activity, taking breaks or modifying the task can be helpful.

2. Ice Therapy: Applying ice to the affected area can help reduce swelling and alleviate pain, particularly during the acute phase of the condition.

3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or aspirin can help reduce inflammation and manage pain.

4. Splinting: Wearing a thumb or wrist splint can provide support and immobilize the affected area, giving the tendons time to heal.

5. Physical Therapy: A hand therapist can guide patients through gentle exercises to strengthen the wrist and thumb and improve flexibility. Stretching and strengthening exercises can prevent recurrence.

6. Corticosteroid Injections: If the pain and inflammation do not respond to conservative treatments, a corticosteroid injection may be used to reduce inflammation and promote healing.

7. Surgery: In rare cases, when other treatments fail, surgery may be necessary to release the tendon sheath and relieve pressure on the tendons. Surgery is typically a last resort and is performed on an outpatient basis.

Preventing De Quervain's Tenosynovitis

While it may not always be possible to prevent De Quervain's, there are several strategies that can help reduce the risk of developing this condition:

• Take Breaks: If you engage in repetitive tasks, take regular breaks to rest your wrist and thumb.
• Use Proper Ergonomics: Pay attention to wrist positioning when typing, texting, or performing other repetitive tasks. Use tools or devices that reduce strain on your wrist.
• Stretch and Strengthen: Incorporate stretching and strengthening exercises for your wrist and hand to improve flexibility and prevent overuse injuries.
• Modify Activities: If possible, alter the way you perform certain tasks to reduce strain on the wrist and thumb.

If you would like any further information, please contact our friendly team on 07 5526 4066 or admin@activehandtherapy.com.au