De Quervain’s Tenosynovitis

There are several tendons in the thumb. Two of these (abductor pollicus longus, and the extensor pollicus brevis) sit within a common sleeve (known as a tendon sheath). Overuse of these tendons will create an inflammation of the tendon sheath via excessive friction where the tendons emerge from the sheath. The tendons are normal. This is common in activities which use the thumb e.g. pruning and sports such as racket sports and golf.

Pain and Symptoms

• Pain will be through the outside of the wrist below the base of the thumb
• Often there may be some swelling over the affected area
• It is usually tender to touch the affected area

Diagnosis

Diagnosis of this condition can usually be confirmed with clinical testing. Imaging such as x-ray, bone scan and ultrasound can also be used to confirm the diagnosis and exclude other injuries.

 Treatment

•  Activity Modification/Rest – A period of activity modification is recommended to help rest.
• Bracing – The wrist and thumb can be supported with a specially made brace to reduce movement
• Medication – Is sometimes advised – prescribed by a doctor.
• Cortisone – Cortisone may be suggested as a form of treatment to help settle the inflammation. This needs to be prescribed and administered by a Doctor
• Strengthening – Long-standing cases can result in weakness to the rest of the hand and arm through disuse.

Recovery

This is highly variable depending on the extent of the problem. Tendon problems often take several months to settle and resistant cases sometimes require a surgical opinion.