common hand conditions
De Quervain’s Tenosynovitis
What is De Quervain’s tenosynovitis?
De Quervain’s tenosynovitis is characterized by pain on the thumb(radial) side of the wrist caused by localized inflammation (synovitis) around the tendons that move the thumb. It is a common condition affecting the hand.
What causes De Quervain’s tenosynovitis?
The extensor tendons of our thumb ( abductor pollicis longus and extensor pollicis brevis) run in a tight compartment over our wrist. The tendons are lined with synovium which provides lubrication and a smooth gliding surface through the extensor sheath(first extensor compartment of the wrist).
When one performs an unaccustomed or excessive, repetitive activity with the hand the increased motion of the tendons results in irritation within the sheath. This irritation causes inflammation(synovitis)
Some patients are more prone to getting De Quervain’s because they have a sub compartment within the 1st compartment causing less space for the tendons.
Examples of common situations that result in De Quervain’s are the following:
- Moms with new born babies, lifting them up and bottle feeding.
- Spring time gardening esp with shears.
- Paddling for the first time.
- Bad ergonomics in the work place.
- DIY around the house.
Do I have De Quervain’s?
They easiest way to check for De Quervain’s is to place your thumb in your palm , make a gentle fist and then tilt the hand towards the little finger side. This test is called Finkelstein’s Test and reproduces the pain in those who have De Quervain’s tensosynovitis.
How is De Quervain’s tenosynovitis treated?
Mild cases can be successfully treated by resting the hand and avoiding the activity causing the problem. Anti inflammatories may help ease the pain.
A local steroid injection next to the inflamed tendons works very well to reduce the swelling and pain. You may require more than 1 injection as the injection typically lasts for 3-4 weeks.
For severe or recurrent De Quervain’s, surgery cures the condition. Surgery entails dividing the roof of the first compartment to release the tendons. It is a quick procedure and is performed as a day case under either general or regional anaesthetic.