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Woman holding the space between her thumb and finger

If you’re experiencing pain and inflammation in your hand, you need an experienced doctor to evaluate your symptoms and determine what the condition may be. The Penn Integrated Hand Program is a team of orthopaedic surgeons and plastic surgeons who work together to provide comprehensive care for tendon problems of the hand, which can be complex and require microsurgery.

Tendonitis and tenosynovitis are different but similar conditions. If tenosynovitis goes untreated, patients risk the affected joint becoming stiff and the tendon becoming permanently restricted.

Treatment for De Quervain's Tenosynovitis

We offer the latest surgical and non-surgical options for de Quervain's tenosynovitis, and we personalize treatment according to your unique needs.

When diagnosing de Quervain’s tenosynovitis, your physician may order a musculoskeletal ultrasound that uses high-resolution imaging to view soft tissues of the hand and wrist. This technology enables physicians to make an accurate diagnosis in order to create a treatment plan that offers the best possible outcome.

Non-Surgical Treatment for De Quervain's Tenosynovitis

If appropriate, we’ll recommend a non-surgical approach first to see if it relieves the pain. Non-surgical treatment options include:

  • Getting a steroid injection to reduce inflammation and relieve the pressure in the tendon sheath
  • Immobilizing the wrist by wearing a splint or brace to rest your thumb and wrist
  • Taking a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin) or naproxen (Aleve)

Surgery for De Quervain's Tenosynovitis

If non-surgical treatment options do not provide relief and your pain becomes too severe, our surgeons will discuss surgical interventions.

Whenever possible, we perform surgery under local anesthesia while the patient is awake in order to minimize the risk of side effects and complications that may occur with general anesthesia. These minimally invasive surgical techniques typically have quicker recovery times and do not require an IV.

For de Quervain's, we often perform a surgical procedure called a release. The goal of a surgical release is to “release” the tendon sheath that wraps around the base of the thumb, relieving pressure and friction and allowing movement.

During the surgical release, we’ll make an incision in the skin on the side of your wrist near the base of your thumb and open the tight band over the swollen part of the tendon. This will allow the tendon to move freely without pain. We’ll then stitch the incision closed.

Our surgeons are highly experienced in this procedure. With proper care during the recovery process, you should be feeling pain-free and getting back to your daily routine in a matter of weeks.

What is De Quervain’s Tenosynovitis?

Tenosynovitis is inflammation of the lining of the tendon sheaths that enclose the tendons. The tendon sheath usually is the part that becomes inflamed, but both the sheath and the tendon can become inflamed simultaneously.

When the tendons and sheaths at the base of the thumb are inflamed, we call it de Quervain's tenosynovitis. The inflammation puts pressure on nerves and causes pain.

Symptoms of De Quervain's Tenosynovitis

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 into your forearm.

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.

In addition, some women experience tenosynovitis during pregnancy and nursing.

De Quervain's Tenosynovitis in Pregnant Women and Nursing Mothers

De Quervain's tenosynovitis may occur in women during pregnancy or after giving birth to their child.

Having to carry and pick up an infant repeatedly who is rapidly gaining weight can cause overuse of the tendons of the wrist near the thumb. It can be very unpleasant, with pain that radiates up and down the forearm.

Whether you are pregnant or are nursing, it is important to seek the right care if you have de Quervain’s. Our orthopaedic and plastic surgeons have treated many pregnant and nursing women with this type of tendonitis. We are highly experienced in women’s health and will collaborate with your obstetrician to provide complete care.

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