De Quervain’s Tenosynovitis: What is it, Causes & Treatment
By Med-Fit Content Team . Last Updated Wednesday, 8th February 2023
What is De Quervain's Tenosynovitis?
De Quervain's Tenosynovitis is a highly painful condition that affects the tendons on the wrist, specifically on the side where the thumb is located. Tendinosis is a term often used to describe the inflammation of these tendons. If you have this particular condition, you are likely to experience significant pain when rotating your wrist, making a fist, or gripping objects.
The precise cause of de Quervain's Tenosynovitis remains largely unknown. However, many activities involving repetitive wrist or hand movements, such as racket sports (tennis, squash, badminton), golf, or gardening, can exacerbate the symptoms and make them more severe.
To better comprehend how this condition affects thumb and wrist movements, it is helpful to understand the functioning of tendons. There are two primary tendons that connect to the thumb, resembling a "pulley system" passing through a fibrous tunnel called a sheath. Tendons can be visualized as rope-like structures that link muscles to bones, covered by a thin layer of soft tissue known as synovium.
When the sheath (tunnel) thickens or the tendons become inflamed, it significantly hampers your range of motion, causing friction and pain during movement.
What Causes De Quervain’s Tenosynovitis?
While the exact causes of Tenosynovitis, as mentioned earlier, are not fully understood, the most commonly associated factor is chronic overuse of the wrist. As previously explained, repetitive wrist movements can lead to irritation and pain.
In addition to overuse, there are other potential causes of Tenosynovitis. Direct injuries to the wrist, such as sprains or strains, can restrict movement and contribute to the condition. Furthermore, certain underlying conditions like Inflammatory Arthritis, including Rheumatoid Arthritis, may also be implicated in the development of Tenosynovitis.
A few other possible reasons why someone may develop de Quervain’s Tenosynovitis could be:
- Repetitive Tasks
- Overuse of wrist
- Hobbies or activities such as Racket Sports or Gardening
You are more likely to develop this condition if you’re:
- A woman
- You have arthritis
- You’re 40 years or older
- Pregnancy – Hormonal changes during pregnancy have been known to cause Tenosynovitis
De Quervain’s Tenosynovitis Symptoms
De Quervain’s Tenosynovitis can gradually or suddenly appear, however there are several symptoms that you will notice quite quickly:
- Swelling and pain at the base of your thumb
- Swelling and pain on the side of your wrist
It may be quite hard and painful to move your thumb well. It can also be quite difficult to grasp objects.
How is Tenosynovitis Diagnosed?
To diagnose de Quervain's Tenosynovitis, your doctor will typically conduct a simple test known as the Finkelstein test. This test helps assess the presence of pain or tenderness in the affected area.
The first step of the Finkelstein test involves bending your thumb so that it rests across your palm. Then, you will be instructed to make a fist, closing your fingers over your thumb. Lastly, the doctor will ask you to bend your wrist towards your little finger.
If you experience pain or tenderness at the base of your thumb during this test, it is likely indicative of Tenosynovitis. In most cases, these initial tests by the doctor are sufficient to diagnose the condition, and additional tests are usually unnecessary.
De Quervain’s Tenosynovitis treatment?
Initiating treatment as early as possible can significantly improve the outcome for Tenosynovitis. Rest is often the initial course of action recommended. While it may seem straightforward, it is crucial to cease activities that potentially trigger or worsen the symptoms, particularly those involving repetitive movements.
To begin addressing the condition, it is advisable to consult with a doctor or a local physical therapist. They will provide proper guidance and set you on the right path towards effective treatment. Sharing your symptoms and seeking professional advice is an essential first step in managing Tenosynovitis.
Some forms of treatment for Tenosynovitis
- Medication – Anti Inflammatory drugs can help with flare ups. Your doctor or local GP may suggest larger doses depending on the levels of pain, swelling and whether you have any additional medical conditions, such as Rheumatoid Arthritis.
- Rest – Resting is the first ‘go to’ treatment when you’re struggling with Tenosynovitis, it gives your body time to heal and stays away from repetitive tasks that will be causing you pain.
- Injection – In some cases the doctor or Local GP may inject you with corticosteroid that helps reduce the inflammation.
Once the pain and swelling begin to go down you should begin to see an increase in your range of motion. There are times when Tenosynovitis becomes quite severe and painful that your physical therapist may give you a set of exercises to help improve your recover and range of motion.
Other forms of treatment for de Quervain’s Tenosynovitis
- Therapeutic Ultrasound Machine – 1 MHz Ultrasound Machines have been known to help those with Tenosynovitis. These types of Ultrasound Machines are some of the most common forms of treatment used in the management of soft tissue lesions with the majority are around rheumatic complaints or soft tissue issues.
- Surgery – In some rare cases there has been a need for surgery. The surgery is aimed at repairing the tendon or remove possible hard parts which are calcium build ups, this naturally causes tendon problems.
- TENS – Tens Machine are also becoming a common form when eyeing up pain relief devices or treatments. Tens machines are used with electrodes that can be placed around the wrist to help with pain relief, however there are other devices that help quite a bit! For those suffering from wrist pain, when using a tens machine there are conductive gloves that cover your whole hand and can be quite effective when cancelling out the pain from Tenosynovitis.