De Quervain's Syndrome

What is De Quervain’s syndrome?

De Quervain’s syndrome (also known as De Quervain’s tenosynovitis) is a painful condition that affects the tendons on the thumb side of the wrist. The condition makes it difficult to make a fist, turn your wrist or grasp anything, while the pain is made worse by repetitive movements, such as playing golf or racquet sports.

What causes De Quervain’s syndrome?

The exact cause of De Quervain’s syndrome is not known but it is often linked to chronic overuse or injury. Two tendons in your wrist and lower thumb normally glide through a smooth tunnel that connects them to the base of the thumb. When the tendons are used repeatedly to make the same motion the sheath that lines them may become irritated, causing it to swell and thicken. This can restrict their movement and cause pain. The condition is also linked to direct injury to the wrist or tendons and rheumatoid arthritis, both of which can restrict the movement of tendons in the wrist.

De Quervain’s syndrome is most common in women between the ages of 30 and 50 and may be associated with pregnancy. It can be made worse by lifting a baby repeatedly using your thumbs as leverage and by jobs that involve making repetitive movements with the hands or wrists.

What are the symptoms of De Quervain’s syndrome?

Symptoms include:

• Pain and swelling at the base of your thumb and wrist
• Difficulty moving your thumb and wrist and making grasping or pinching movements
• A feeling that your thumb is sticking when you move it

If the condition is not treated, the pain may spread along the thumb into your forearm.

How is De Quervain’s syndrome diagnosed?

Your consultant will examine your hand and wrist and they may also need an ultrasound scan. Finkelstein’s test involves bending your thumb across the palm of your hand and bending your fingers down over your thumb. Your consultant will then ask you to bend your wrist toward your little finger. If you experience pain on the thumb side of your wrist, you are likely to be suffering from De Quervain’s syndrome.

How is De Quervain’s syndrome treated?

Treatment for De Quervain’s syndrome focuses on reducing inflammation and restoring movement to the thumb. You may need to wear a splint or brace to immobilise your thumb and wrist for a short period and ice can be used to reduce inflammation. Medication can be used to relieve pain and reduce inflammation and injections of corticosteroids into the tendon sheath may help to reduce swelling. A physiotherapist or occupational therapist can review how you are using your wrist and suggest adjustments to relieve stress and strengthen your muscles. In serious cases, you may need surgery to open up the sheath surrounding the inflamed tendons and relieve pressure.