De Quervain’s tenosynovitis is a painful inflammation of the tendons in the wrist and lower thumb. Repetitive movements can make the condition worse.
It’s most common in women over 40 and is often caused by lifting a young child or carrying heavy bags.
Real-life causes
“I’m a new mum/dad/grandparent.”
“I regularly play golf/tennis/garden/do needlework.”
Diagnosis
If you’re experiencing pain at the wrists and base of your thumb, and/or notice increasing pain when lifting, you should seek a referral to us from your GP. Our hand therapists will carry out a thorough assessment during your first appointment to confirm the diagnosis.
Treatment
Splinting is the most common treatment for De Quervain’s. You can purchase off-the-shelf thumb and wrist supports online or at your local pharmacy. However, we highly recommend custom-moulded splints.
After your initial consultation, your hand therapist will design and make your custom-splint so that it caters to your individual needs. They’ll also teach you exercises and help you figure out other ways to carry out tasks, such as holding your baby, to avoid repetitive strain on your wrist and thumb.
Recovery
If you start your treatment early and complete the exercises recommended by your hand therapist, your symptoms should improve within 4-6 weeks. Exercises for the wrist, arm and hand will reduce pain and limit tendon irritation.
Do you need surgery for De Quervain’s?
If your symptoms persist despite these treatments, you may need to be referred to a hand specialist. Cortisone injections will likely be recommended as the first course of action. These effectively treat the problem in many cases.
In cases where injections are unsuccessful, surgery to open the tendon sheath and release pressure on the tendon may be required. The operation is usually performed under local anaesthetic.
Post-operative care
After surgery, you’ll be advised to keep your hand raised and bandaged initially. During this time, it’s important that you gently exercise your fingers, elbow and shoulder to prevent stiffness.
Your hand therapist will see generally see you in the first two weeks after surgery and start exercises. Stretches post recovery are essential to regaining pain-free function.
Possible complications of De Quervain’s
- If left untreated, pain can spread up the forearm or down the thumb
- Reoccurrence of symptoms
- Infection at the surgical incision site
- Nerve or tendon damage during surgery