De Quervains Tendonitis
What is De Quervain’s Tendonitis?
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. Tendons are like ropes that muscles use to pull the bone.
When you straighten your fingers, you can see the affected tendon on the back of your hand. In de Quervain syndrome, the tunnel sheath containing the tendon narrows because of thickening of the tunnel’s soft tissues. That narrowing causes pain during hand and thumb motion, especially with forceful twisting or grasping.
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 the point 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.
People of all ages develop de Quervain syndrome. There is a prevalence of it in new mothers, and it most commonly presents in them 4-6 weeks after the baby’s birth. An old wives tale was that wringing out cloth diapers brought it on, which has been replaced by guesses that it’s due to holding a baby awkwardly, but hormones and inflammation post-pregnancy are more likely to blame.
Rheumatoid arthritis, an autoimmune inflammatory disease of the joint tissues, can also cause De Quervain’s tendonitis in pregnant women.
Sign & Symptoms
The thumb side of the wrist is the core area affected, and the sensation can range from pain to a catching feeling when moving the thumb. Pain can travel up the forearm, and a fluid-filled cyst at the base of the thumb can form due to a weakened spot in the lining of the wrist joint.
- Pain that worsens with hand and thumb movement
- Swelling over the thumb side of the wrist
- A catching sensation when moving the thumb
Diagnosis & Treatment
Non-surgical treatment options include a thumb splint to immobilize the joint for healing and pain reduction, medication (aspirin or NSAIDs), rest and adjusting movement for some tasks, physical and occupational therapy, topical creams, and soaking in warm water.
If those efforts do not alleviate symptoms, there is a surgical option. The symptoms of De Quervain’s tendonitis can be readily resolved through a 10-minute endoscopic procedure, under local or general anesthesia. Your Houston 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. We call this the “No Stitch Procedure,” and it’s what we’re known for.
Recovery is usually quick, with normal activities resumed in 2-3 weeks.