De Quervain Tenosynovitis

De Quervain's tenosynovitis is a wrist problem that causes pain on the thumb side. It happens when the tendons that help you move your thumb and wrist get inflamed. This inflammation makes it uncomfortable to move your wrist, grip things, or make a fist.

Doctors don't know exactly why this happens, but activities that use your hands and wrists repeatedly can worsen the condition. For example, gardening, playing sports like golf or tennis, or even holding a baby for long periods can put extra stress on the affected tendons, leading to pain and inflammation.

De Quervain's tenosynovitis is a condition that causes pain and swelling in the wrist and thumb area. It happens when the tendons that control movement of your thumb and wrist become inflamed. Here's what you need to know about the symptoms:

Common Symptoms:

• Pain: You'll likely feel pain near the base of your thumb. This is where the tendons that move your thumb are located.
• Swelling: Inflammation can cause swelling, also noticeable near the base of your thumb.
• Limited Movement: Moving your thumb and wrist, especially when you're grasping or pinching, might be difficult. You might feel like your thumb is "sticking" or getting stuck momentarily. This can make everyday tasks like holding a cup or using a screwdriver harder.
• Increased Pain with Movement: If the condition persists without treatment, the pain could spread to your thumb or forearm. Moving your thumb and wrist will likely worsen the discomfort.

When to See a Doctor:

If you're experiencing these symptoms, and you've already tried these self-care measures, it's important to see your doctor:

• Avoiding use of the affected thumb: If you've already tried resting your thumb, but the pain or limited movement persists.
• Applying ice: If applying ice packs to the area hasn't helped reduce pain or swelling.
• Taking over-the-counter pain relievers: If using ibuprofen or naproxen (common pain relievers) doesn't provide enough relief.

These self-care steps can help ease mild symptoms, but if your discomfort continues or worsens, it's essential to consult a healthcare professional for a proper diagnosis and treatment plan. They can determine the best course of action, which may include various therapies or potentially, cortisone injections or surgery.

If you're still experiencing pain or trouble using your thumb after trying these simple things, talk to your doctor:

• Avoiding use of your thumb: This means not using it for everyday tasks.
• Applying ice: Putting ice packs on the affected area can help reduce swelling and pain.
• Taking over-the-counter pain relievers: Drugs like ibuprofen (found in Advil and Motrin) and naproxen (in Aleve) can ease pain and inflammation.

If these home remedies aren't helping, it's important to see a healthcare professional for further evaluation and potential treatment options.

Carpal tunnel syndrome isn't the only wrist problem that can cause pain. De Quervain's tenosynovitis affects the tendons on the thumb side of your wrist. These tendons, which are like tiny ropes connecting muscles to your bones, normally slide easily through a small tunnel near the base of your thumb.

Think of the tunnel as a smooth pathway for these tendons. If you repeatedly do the same hand motions, day after day, you might irritate the protective sheath around these tendons. This irritation can lead to the sheath thickening and swelling. This swelling makes it harder for the tendons to glide smoothly through the tunnel, causing pain and stiffness in your wrist and thumb.

This repetitive motion is a common cause, but other things can also trigger De Quervain's:

• Inflammation: Certain types of arthritis, like rheumatoid arthritis, can cause inflammation that irritates the tendons and the tunnel they pass through.
• Injury: A direct blow or injury to your wrist or tendons can lead to scar tissue formation. This scar tissue can narrow the tunnel and restrict the tendons' movement.
• Hormonal changes: Changes in hormones, like those that occur during pregnancy, can sometimes lead to fluid retention, which can also put pressure on the tendons and the tunnel.

In short, De Quervain's happens when the tendons on the thumb side of your wrist get irritated and swollen, making it difficult for them to move freely through the tunnel. This can cause pain and limited movement.

De Quervain's tenosynovitis is a condition that causes pain in the wrist and thumb. Several things can increase your chances of getting it.

• Age: People in their 30s and 40s are more likely to develop this condition than younger or older people. Children are also less likely to get it.

• Gender: Women are more likely to experience de Quervain's tenosynovitis than men.

• Pregnancy: The hormonal changes and physical demands of pregnancy might play a role in the development of this condition.

• Childcare: Frequently lifting and holding babies, especially using your thumbs for support, can put stress on the tendons and increase your risk.

• Repetitive Hand and Wrist Motions: Jobs or hobbies that involve repeatedly moving your hands and wrists, like typing, playing certain musical instruments, or using tools, may contribute to the issue. The constant strain on the tendons in your wrist can lead to inflammation and pain.

If you don't treat de Quervain's tenosynovitis, it can make it hard to move your hand and wrist normally. You might find your wrist doesn't bend or move as much as it used to.

Doctors diagnose de Quervain's tenosynovitis by checking your hand. They'll feel for pain when they press on the thumb side of your wrist. They might also ask you to do a simple test called the Finkelstein test. To do this, bend your thumb into the palm of your hand, and curl your fingers over your thumb. Then, bend your wrist towards your pinky finger. If this movement causes pain on the thumb side of your wrist, it's a strong sign of de Quervain's tenosynovitis.

X-rays and other imaging tests aren't usually needed to diagnose this condition. The physical exam and the Finkelstein test are typically enough for the doctor to make the diagnosis.

De Quervain's tenosynovitis is a condition causing inflammation around the tendons in your thumb and wrist. The goal of treatment is to reduce this inflammation, keep your thumb and wrist moving, and prevent future problems. Early treatment usually leads to improvement within 4 to 6 weeks. If the condition develops during pregnancy, symptoms often resolve after pregnancy or breastfeeding ends.

Pain Relief:

To ease pain and swelling, your doctor might suggest over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve). They may also recommend corticosteroid injections directly into the tendon sheath. If treatment starts within the first six months of symptoms, a single corticosteroid injection often leads to a complete recovery.

Conservative Treatments (Non-Surgical):

These methods are often tried first:

• Immobilization: A splint or brace will keep your thumb and wrist straight, allowing the tendons to rest.
• Avoiding Repetitive Movements: Try to minimize activities that use your thumb repeatedly.
• Avoiding Pinching: Don't pinch or use your thumb to grip while moving your wrist side-to-side.
• Ice: Apply ice to the affected area to reduce swelling and pain.
• Physical Therapy: A physical therapist or occupational therapist can help you understand how you use your wrist and suggest ways to reduce stress on it. They can also teach you exercises to strengthen your wrist, hand, and arm muscles, easing pain and reducing irritation of the tendons.

Surgery (For Severe Cases):

In more severe cases, surgery may be necessary. This is typically an outpatient procedure. During surgery, the doctor carefully examines the tendon sheath and opens it to relieve pressure, allowing the tendons to move smoothly. After surgery, your healthcare provider will advise you on how to properly rest, strengthen, and rehabilitate your body. A physical therapist or occupational therapist will likely follow up to teach you new strengthening exercises and adjustments to your daily routine to prevent future problems.

Important Note: It's essential to follow your doctor's recommendations for treatment and recovery. If you are experiencing symptoms of De Quervain's tenosynovitis, schedule an appointment with your healthcare provider.