De Quervain’s tenosynovitus 

What is de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a condition where the synovial membrane, the protective sheath or layer enclosing the tendons, becomes inflamed at the base of the thumb. The inflammation puts pressure on nerves and causes pain and swelling along the thumb side of the wrist. It’s sometimes known as “thumb tendinitis” or “tendinitis of the wrist and thumb,” although tenosynovitis is slightly different than tendinitis, which inflames the tendons themselves rather than their protective sheath.

Experts at Penn Orthopaedics specialize in the complex structures of the hand and wrist, offering comprehensive care for hand and wrist pain, including the latest surgical and nonsurgical options for de Quervain’s tenosynovitis.

De Quervain’s tenosynovitis symptoms

The main symptom of de Quervain’s tenosynovitis is pain at the base of the thumb. You may also experience numbness along the thumb and index finger and sometimes in your forearm. Some people experience pain that radiates up and down the forearm. Other symptoms may include:

  • Swelling on the thumb side of the wrist, sometimes with a fluid-filled cyst
  • Trouble moving the thumb and wrist due to pain and swelling
  • A catching or snapping feeling when moving the thumb
  • Tenderness at the thumb’s base, especially when pressing the area
  • Pain with specific actions like making a fist, gripping objects, turning the wrist, or lifting with thumbs up

What causes de Quervain’s tenosynovitis?

Most often, de Quervain’s tenosynovitis occurs from strain, overuse or repetitive movement, or injury or trauma to the thumb. It can sometimes be caused by inflammatory conditions, such as rheumatoid arthritis.

De Quervain’s tenosynovitis may also occur during pregnancy or nursing due to hormonal changes, fluid retention, and infant care activities that impose additional stress on the wrists and thumbs. Our orthopaedic and plastic surgeons treat many pregnant and nursing women with this type of tendonitis and collaborate with women’s health providers to provide complete care.

Diagnosing de Quervain’s tenosynovitis

When diagnosing de Quervain’s tenosynovitis, your doctor will ask about any activities that may have caused your symptoms. A physical examination will probably include the Finkelstein test, where you’ll be directed to make a fist with the thumb inside the fingers. Your doctor will then gently bend the wrist toward the little finger. If that causes a sharp pain on the thumb side of your wrist, it likely confirms a de Quervain’s tenosynovitis diagnosis. Your doctor may also order imaging tests to rule out arthritis or bone fractures, or to view soft tissues.

Treatment for de Quervain’s tenosynovitis

Your Penn Orthopaedics care team will usually recommend nonsurgical approaches first, like taking nonsteroidal anti-inflammatory drugs (NSAIDs). Other options include steroid injections and splinting or bracing the thumb and wrist to immobilize them and encourage rest. If nonsurgical treatments don’t provide sufficient relief, your doctor may recommend a minimally invasive surgical treatment.

Expert care for hand and wrist pain

The specialists at Penn Orthopaedics bring extensive experience to diagnosing and treating a wide range of hand and wrist conditions, including de Quervain’s tenosynovitis. Our team of orthopaedic surgeons and plastic surgeons work together to provide comprehensive care for even the most complex cases. We use the latest surgical and nonsurgical techniques and create individualized treatment plans to help relieve pain and restore flexibility. Our integrated care is also designed for your convenience, with specialists, imaging services, and physical therapy often available at a single location in the southeastern Pennsylvania and New Jersey regions.

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