De Quervain's tendonitis refers to a swollen tendon that limits the movement of the thumb or makes the movement painful, particularly with extension or stretching of the thumb.
The trademark symptoms of De Quervain's tendonitis are:
- Pain over the thumb side of the wrist (sometimes traveling up the forearm)
- Pain that worsens with hand and thumb movement
- Swelling over the thumb side of the wrist
- A catching sensation when moving the thumb
Sometimes a fluid-filled cyst at the base of the thumb may form as a result of a weakened area in the lining of the wrist joint.
De Quervain's tendonitis may develop from overuse of the thumb, causing the tendon that attaches the extensor muscles in the forearm to the thumb. The tendon becomes inflamed and swells to where it can no longer slide easily in the tunnel of tissue (tendon sheath) that contains it. This also places pressure on the median nerve, causing pain. Rheumatoid arthritis, an autoimmune inflammatory disease of the joint tissues, can also cause De Quervain's tendonitis in pregnant women.
- Thumb splint to immobilize the joint for healing and pain reduction
- Medications: aspirin or NSAIDs are helpful to reduce swelling and pain
- Rest: adjusting to different ways of performing tasks while healing takes place
- Physical and occupational therapy: stretching, strengthening and ultrasound therapies are commonly applied
- Topical creams: though not curative, these can temporarily reduce pain
- Soaking: after initial flare-up, soaking in warm water can help alleviate pain and promote blood circulation to the joint to promote healing.
The symptoms of De Quervain's tendonitis can be readily resolved through a 10-minute endoscopic procedure, under local or general anesthesia. Your surgeon makes a tiny incision at the base of the thumb and uses a camera-guided scope to release the constricted tissues of the tunnel (sheath) to restore easy movement of the tendon that extends to the thumb. Recovery is usually quick, with normal activities resumed in 2-3 weeks.