De Quervain’s Tenosynovitis

De Quervain’s Tenosynovitis is a painful inflammatory condition of the tendons at the side of your wrist. These tendons include 1. The Extensor Pollicis Brevis (EPB) and 2. Abductor Pollicis Longus (APL). The muscles are located at the dorsal side of the forearm and go through the lateral side of the thumb through a fibrous osseous tunnel. Overuse or repetitive movements of these structures can lead to inflammation and cause pain in the region. The pain gets worst with abduction of the thumb, ulnar deviation of the wrist, and grasping action of the hand.

Signs and Symptoms of De Quervain’s Tenosynovitis?

• Pain and or swelling near the base of the thumb
• Difficulty moving your thumb/wrist
• Pain with grasping or pinching
• A “sticking” sensation in your thumb when moving it

Causes of De Quervain’s Tenosynovitis?

• Attributed to myxoid degeneration (the connective tissue replaced by a gelatinous substance)
• Associated with repetitive wrist motions- radial deviation of the wrist and thumb radial abduction/extension
• Mothers of newborns- repeatedly lifting a newborn with the above movements
• Chronic overuse
• Activities such as playing the piano, golfing, carpentry, musical instruments can lead to chronic overuse
• Repetitive gripping, grasping, pinching, clenching can lead to inflammation of the tendon and tendon sheath
• If this condition is left untreated, it can lead to build up of scar tissue that will further limit mobility

Treatment Options?

• Wrist & thumb splint
• Ice
• Avoid aggravating movements
• NSAID’s