De Quervain’s tendonitis is a condition that results from irritation or swelling of the tendons along the thumb side of the wrist – generally prompted by awkward hand positions. The irritation causes the lining around the tendon to swell, changing the shape of the compartment and making it difficult for the tendons to move as they should.
Those suffering from the condition may experience pain on the thumb side of the wrist and tenderness when forming a fist, grasping and gripping and twisting the wrist. Swelling is noticeable and may be accompanied by a cyst filled with fluid. They may also experience a “snapping” when the thumb is moved and find pinching difficult.
If the nerve lying on top of the tendon sheath becomes irritated, patients may also experience numbness on the back of the thumb and index finger.
Those at Risk
This condition is commonly found in those required to use their hands in new and awkward positions for a period of time – such as a new mother feeding an infant a bottle or pushing a stroller, or someone learning to play the piano.
A test is performed to confirm the presence of De Quervain’s tendonitis. It requires the patient to make a fist with the fingers over the thumb. The wrist is then bent towards the little finger and the level of discomfort and difficult of movement is assessed. Patients also report tenderness directly over the tendons on the thumb side wrist.
Treatment may consist of simply refraining from the activity that prompted the swelling, or involve the use of anti-inflammatory medication to reduce swelling and relieve pain. When the condition is non responsive to conservative treatment, surgery to open the compartment, or sheath, and widen the constricted area for the irritated tendons is performed.
Rehabilitation and strengthening exercises are established following surgery.