De Quervain's Tenosynovitis
(De Quervain’s Syndrome, De Quervain’s Disease, Washerwoman’s Sprain)
De Quervain's tenosynovitis is an inflammation of the sheaths of the tendons that move the thumb up and out (away from the hand). It is technically referred to as a stenosing tenosynovitis because both the tendons and their surrounding tissue sheaths are involved, in which the tendon has to go through a small fibro-osseous tunnel at the wrist. The inflamed tenosynovium becomes painful at the tunnel area.
Like tennis elbow and carpal tunnel syndrome, it is a condition often brought about by overuse. In this case a wringing action of the wrists is most frequently responsible—hence “washerwoman’s sprain.”
It is far more common in women than in men. New mothers may develop DeQuervain’s tenosynovitis from picking up their newborn babies. It is not associated with any systemic disease nor dangerous condition, but it usually requires medical treatment to resolve.
DeQuervain’s is a purely mechanical problem caused by repetitive use of the thumb and wrists.
The most common way to get DeQuervain’s tenosynovitis is by certain repetitive movements of your hands and wrists. A direct blow to the area may also initiate the condition. Rheumatoid arthritis and similar diseases may set it off.
Wrist pain may be due to several conditions besides DeQuervain’s tenosynovitis. If your wrist is hurting, see your physician.
- Pain in the wrist below the thumb that worsens with use
Your doctor will ask about your symptoms and medical history, and perform a physical exam. You maybe referred to an orthopedic surgeon for treatment.
The definitive diagnosis of DeQuervain’s tenosynovitis is the Finkelstein test:
Curl your fingers over your thumb (make a fist with your thumb inside your fingers) and bend your wrist toward your little finger. If this causes pain at the wrist below your thumb, you probably have DeQuervain’s tenosynovitis.
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Rest, splinting, hot and cold packs, therapeutic ultrasound, exercises, and over-the-counter pain relievers rarely provide adequate relief.
An injection of a cortisone-like drug into the tendon sheath is 70%-90% effective in curing the condition.
When all else fails, an orthopedic surgeon will open up the fibro-osseous tunnel and possibly remove some of the tendon sheath to allow the tendon(s) more room to move. This procedure can be done under local anesthesia.
To help reduce your chances of getting De Quervain's, take the following steps:
- Minimize twisting and gripping activities