De Quervain’s tendinosis, also known as De Quervain’s tenosynovitis, is a condition that affects the tendons in the wrist and thumb. It is caused by inflammation or irritation of the tendons that control the movement of the thumb.
The tendons involved in De Quervain’s tendinosis are the abductor pollicis longus and extensor pollicis brevis tendons. These tendons run along the side of the wrist and pass through a narrow tunnel called the first dorsal compartment. When these tendons become inflamed or irritated, they can cause pain and swelling at the base of the thumb and wrist.
Common symptoms of De Quervain’s tendinosis include:
De Quervain’s tendinosis can be caused by repetitive motions that involve gripping or twisting, such as playing a musical instrument, using tools, or holding a baby. It can also be caused by direct injury to the affected area.
The exact cause of De Quervain’s tendinosis is not always clear, but several factors may contribute to its development. These include:
Repetitive Motion: Activities that involve repetitive gripping, grasping, or twisting, such as playing a musical instrument, using tools, or holding a baby, can increase the risk of developing De Quervain’s tendinosis.
Direct Injury: A direct injury to the affected area, such as a fall or blow to the wrist or thumb, can cause inflammation and lead to De Quervain’s tendinosis.
Anatomical Factors: Some people may be more prone to developing De Quervain’s tendinosis due to anatomical factors, such as a narrower first dorsal compartment or a tendinous attachment that is closer to the bone.
Age and Gender: De Quervain’s tendinosis is more common in women than men, and it tends to occur more frequently in people over the age of 40.
Medical Conditions: Certain medical conditions, such as rheumatoid arthritis, diabetes, and thyroid disease, can increase the risk of developing De Quervain’s tendinosis.
To diagnose De Quervain’s tendinosis, a doctor will typically perform a physical exam and review your medical history. During the physical exam, the doctor will assess the affected hand and wrist for signs of swelling, tenderness, and pain.
The doctor may also perform a Finkelstein test, which involves making a fist with the thumb inside the fingers and bending the wrist toward the little finger. If De Quervain’s tendinosis is present, this movement will cause pain at the base of the thumb.
In some cases, the doctor may perform additional tests, such as an X-ray or MRI, to rule out other conditions that can cause similar symptoms, such as a fracture or arthritis.
Treatments for De Quervain’s tendinosis may include:
Rest and Immobilization: Avoiding activities that exacerbate the symptoms and immobilizing the affected thumb and wrist with a splint or brace can help reduce pain and inflammation.
Ice and Heat Therapy: Applying ice packs or heat to the affected area can help reduce swelling and alleviate pain.
Medications: Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can help relieve pain and reduce inflammation.
Physical Therapy: Exercises to improve strength, flexibility, and range of motion in the thumb and wrist can be helpful in reducing symptoms and preventing recurrence.
Corticosteroid Injection: A corticosteroid injection directly into the affected area can help reduce inflammation and relieve pain.
Surgery: In severe cases, surgery may be necessary to release the constricted tendon sheath and restore normal thumb and wrist movement.