DeQuervain's Tenosynovitis, also known as stenosing tenosynovitis, is a condition that affects the tendons in the thumb. It is characterized by pain, swelling and stiffness in thumb and wrist. This condition is caused by inflammation of the tendons and the synovium, which is the protective lining around the tendons. The condition is common in women and people over the age of 40.
Causes of DeQuervain's Tenosynovitis
DeQuervain's Tenosynovitis is caused by overuse or repetitive motions of the thumb and wrist. This can include activities such as typing, texting, knitting, and even gripping a steering wheel. Other factors that can contribute to the development of DeQuervain's Tenosynovitis include:
Trauma to the thumb or wrist
Symptoms of DeQuervain's Tenosynovitis
The symptoms of DeQuervain's Tenosynovitis can vary from person to person. The most common symptoms include:
Pain and swelling at the base of the thumb
Stiffness in the thumb and wrist
Pain that worsens with gripping or grasping objects
A "catching" or "snapping" sensation in the thumb
Diagnosis of DeQuervain's Tenosynovitis
DeQuervain's Tenosynovitis is typically diagnosed by a doctor who will take a medical history and perform a thorough clinical examination of the hand, wrist, elbow shoulder and the neck. They will also likely perform a Finkelstein test, this is a specific and sensitive test which involves making a fist and then bending the thumb towards the little finger. Pain or a "catching" sensation during this test is indicative of DeQuervain's Tenosynovitis. Ultrasound can also be used to confirm the diagnosis by visualizing the inflammation of the tendons and synovium.
Treatment of DeQuervain's Tenosynovitis
Treatment for DeQuervain's Tenosynovitis typically begins with conservative measures such as rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation. A splint or brace may also be recommended to immobilize the affected area and allow it to heal.
Physiotherapy can also be beneficial in treating DeQuervain's Tenosynovitis. A physiotherapist can teach exercises that will help to stretch and strengthen the tendons and muscles in the affected area. They can also teach techniques for proper posture and body mechanics that can help to prevent future occurrences of the condition.
If conservative measures do not provide relief, the doctor may recommend a corticosteroid injection to reduce inflammation. Ultrasound guided steroid injections can be a very effective treatment option for DeQuervain's Tenosynovitis as it allows for precise delivery of the medication to the affected area. In severe cases, surgery may be necessary to release the tendons from the tight sheath that surrounds them.
Prevention of DeQuervain's Tenosynovitis
To prevent the development of DeQuervain's Tenosynovitis, it is important to avoid activities that put repetitive stress on the thumb and wrist. This may include avoiding prolonged gripping or grasping activities, taking frequent breaks during activities such as typing or knitting, and using ergonomic tools.
It is also important to make adjustments as needed to reduce the stress on your thumb and wrist. This may include adjusting your typing or knitting technique, using ergonomic tools, and taking frequent breaks during activities that put repetitive stress on your thumb and wrist.
DeQuervain's Tenosynovitis can be a painful and debilitating condition , but with proper diagnosis and treatment, most people are able to find relief from their symptoms. If you suspect you may have DeQuervain's Tenosynovitis, it is important to seek medical attention as soon as possible. Early diagnosis and treatment can help to prevent the condition from becoming worse and can help to minimize the risk of complications.
In conclusion, DeQuervain's Tenosynovitis is a condition that affects the tendons in the thumb and is characterized by pain, swelling, and stiffness in the thumb and wrist. It is caused by inflammation of the tendons and synovium, which is the protective lining around the tendons. With proper diagnosis and treatment, most people are able to find relief from their symptoms and prevent the condition from becoming worse. It is also important to be mindful of your daily activities, make adjustments as needed, and maintain a healthy lifestyle to reduce the risk of developing DeQuervain's Tenosynovitis or other conditions.
If you are experiencing symptoms of DeQuervain's Tenosynovitis, don't hesitate to book an appointment at ACTIVATE Musculoskeletal Clinic in Kent for a thorough evaluation and individualized treatment plan.
About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.