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Find out how De Quervain's tenosynovitis is diagnosed and treated
It arises when the 2 tendons (extensor pollicis brevis and abductor pollicis longus) become inflamed as they cross the wrist joint usually as a result of repetitive activity at the wrist. The 2 muscles are located in the lower forearm and run across the wrist to attach at the thumb.
The tendons are contained in a sheath, under normal circumstances they freely slide through to produce the thumb movements needed, but if subject to excessive repetitive activity they become painful and inflamed.
It is not known exactly why this occurs but this condition occurs commonly in people doing repetitive activity at the wrist e.g. bar staff and occurs during pregnancy or post-partum possibly as a result of hormonal changes or excessive lifting of the newborn baby.
De Quervain’s tenosynovitis can be managed very effectively in almost all cases with non-surgical management.
Modifying any wrist and hand positions used for lifting or reducing any sustained period of time with touch screen devices such as tablets and smartphones may also allow any inflammation and pain to settle in the tendons and sheaths.
The application of anti-inflammatory gel to the painful area may ease pain and help settle the inflammation. Similarly, ice applied appropriately through a damp cloth for short periods to avoid an “ice burn” may ease symptoms.
Wearing a splint supports the thumb and allows any inflammation and pain in the tendons and sheath to settle.
A referral may be suggested as an alternative to injection in some cases or if advice is needed on activity modification.
For individuals with De Quervain’s tenosynovitis who continue to suffer disabling symptoms in spite of appropriate use of splints and activity modification a corticosteroid injection can be offered as the next line of treatment. You can read more about local corticosteroid injections here.
De Quervain’s decompression surgery is an effective option for individuals who: