De Quervain’s Tenosynovitis: What is it, Causes & Treatment
What is Tenosynovitis?
De Quervain’s Tenosynovitis is an incredibly painful condition that affects the tendons on wrist that can be found on the same side as the thumb. The word Tendinosis usually refers to the swelling of the tendons. If you have this specific condition, it will likely hurt quite a bit when you turn your wrist, make a first or grasp anything.
The exact cause of de Quervain’s Tenosynovitis is quite unknown; however, most activities rely on repetitive wrist or hand movements – these include racket sports (tennis, squash, badminton etc), golf, working on the garden and many similar activities can in fact make your symptoms far worse.
The best way to explain how this condition can affect your thumb and wrist movements is to understand how the tendons work. There are two main tendons that connect to the thumb. You could describe these Tendons as a ‘pulley system’ that passes through a fibrous tunnel called a sheath. Tendons look a little like a rope structure that attached muscle to bone, and they’re covered by a thin soft tissue layer – this is called synovium.
When the sheath (tunnel) thickens or if the tendons swell, this will naturally have a negative affect on your movement and cause friction and pain.
What Causes De Quervain’s Tenosynovitis?
The exact causes as mentioned above for Tenosynovitis are still quite unknown, however, they have linked with the most common complaint / cause – this is chronic overuse of the wrist. Briefly described above, the repetitive movements in the wrist can cause irritation and pain.
Other possible causes could include direct injuries to the wrist that could restrict your movement or other conditions such as Inflammatory Arthritis (Rheumatoid Arthritis).
A few other possible reasons why someone may develop de Quervain’s Tenosynovitis could be:
- Repetitive Tasks
- Overuse of wrist
- Gaming
- 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?
Your doctor will employ a simple test to understand whether you have de Quervain’s Tenosynovitis – normally called Finkelstein test. The first stage of the test will be to see if you can bend your thumb so it rests across your palm, then you will be told to make a first which will close your fingers over your thumb.
The last part of the test, the doctor will have you bend your wrist toward your little finger – if you have pain or tenderness at the base of your thumb – the likely result of the test will show you have Tenosynovitis.
If these tests are inclusive, there are other tests that can show whether you have this condition, however, they are not usually needed to help diagnose the condition after the first stage of tests by the doctor.
De Quervain’s Tenosynovitis treatment?
The quicker you start treatment the better It will work for you, however, rest is usually the first treatment. It may sound a bit simple, however you need to stop the things that are possibly causing the symptoms – especially things that make you carry out repetitive movements.
The first stages would be to discuss your symptoms with a doctor or local physical therapist as they will be able to send you on the correct path.
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 – 3 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.
