De Quervain Tenosynovitis - What Is It?
Have you ever experienced pain at the base of your thumb and wrist? If so, you may have had a condition called De Quervain Tenosynovitis.
It's a painful condition affecting the tendons on the thumb side of the wrist. You will probably feel pain when you turn your wrist, grasp anything, or make a fist. The tendons that run along the thumb side of the wrist and attach to the base of the thumb can swell. This occurs when the tendons are constricted by the sheath that they run through to get from the wrist to the hand.
What is De Quervain Tenosynovitis?
De Quervain Tenosynovitis, or as I will abbreviate as DQT for the duration of this post, is a condition which involves tendon entrapment affecting the dorsal compartment of the wrist. This was named after the Swiss surgeon, Fritz de Quervain, who first described it in 1895. The tendon sheaths of the abductor pollicis longus and extensor pollicis brevis thicken and have a difficult time passing through the fibro-osseous tunnel located along the radial styloid at the distal wrist. In other words, tendons become thickened and inflamed and get stuck. See the graphic below for reference.
What causes De Quervain Tenosynovitis?
Although the exact cause of DQT isn't known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports, or lifting a baby — can make it worse. Overuse is one of the most common problems. This condition can occur for a variety of reasons, but it is most common in postpartum women, or people who carry and hold babies or children often. It is also common in people who use their wrists a lot for work or hobbies.
Other causes can include:
Inflammatory arthritis (such as rheumatoid arthritis)
Direct injury to the wrist or tendon
Pregnancy and Breastfeeding
Fluid retention (such as from changes in hormones during pregnancy)
How do you treat DQT (De Quervain Tenosynovitis)?
Apply ice, kinesiotape, topical analgesics, stretch the tendons, mobilize the wrist, perform cross friction massage (I recommend using a guasha tool), cold laser (performed by a trained healthcare practitioner), and in some cases you may consider a brace.
Treatment for De Quervain Tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence. If you start treatment early, your symptoms should improve within 4 to 6 weeks. If DQT starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breastfeeding.
To reduce pain and swelling, your doctor may recommend using pain relievers such as Ibuprofen, Advil, Motrin, and/or Aleve. Your doctor may also recommend injections of corticosteroid medications into the tendon covering to reduce swelling. You may also see a physical therapist or an occupational therapist to strengthen your muscles, reduce pain, and limit tendon irritation.
ANH Wellness can help you with De Quervain Tenosynovitis!
This is something we see often and treat regularly in our office due to the amount of postpartum patients we see. Most people with DQT do very well with therapies and are ultimately relieved of their symptoms overall. Other patients can be successfully treated non-surgically with splints, NSAIDs, and injections.
If you are experiencing wrist pain we would be happy to help!
By: Dr. Laudeman
Chiropractor at ANH Wellness