De Quervain’s Tenosynovitis

What is De Quervain’s Tenosynovitis?

De Quervain’s Tenosynovitis is a condition caused by entrapment of some of the tendons going to your thumb. These tendons, called the abductor pollicis longus and the extensor pollicis brevis, go through a snug tunnel at the wrist, called the first dorsal extensor compartment. You can see the tendons on the back of your hand when you straighten your fingers. When, for whatever reason, the tunnel becomes too tight, it sets up a vicious cycle; whenever you move your thumb in certain ways, it pulls the tendons through the tight tunnel, causing pain and further aggravating the condition.

What causes it?

Doctors are not sure what causes de Quervain syndrome. There seems to be some genetic component, as certain people have many related problems such as trigger fingers or carpal tunnel syndrome.  Some think that overuse may contribute, along with generalized swelling or conditions such as diabetes and thyroid disease.

Signs and symptoms

Patients with de Quervain’s Tenosynovitis often describe a feeling of sharp or dull pain and swelling. This is either at the base of the thumb or at the wrist. People of all ages can experience these problems.

Treatment

Dr. Daniel Singer performs a de Quervain’s Tenosynovitis injection.

Treatments that can relieve symptoms include:

• A splint that stops you from moving your thumb and wrist.
• Tylenol or aspirin type medications (e.g., ibuprofen).

Treatments that attempt to change the course of the disease include:

• A cortisone-type of steroid injection into the tendon compartment.
• Surgery to open the tunnel and make more room for the tendons.

American Society for Surgery of the Hand, 2017, De Quervain’s Tenosynovitis, https://www.assh.org/handcare/condition/dequervains-tenosynovitis