deQuervain's tendinitis is a condition
brought on by irritation or swelling of the tendons found along the thumb side of the
wrist (Figure 1). The irritation causes the compartment (lining) around the tendon to
swell, changing the shape of the compartment; this makes it difficult for the tendons to
move as they should. The swelling can cause pain and tenderness along the thumb side of
the wrist, usually noticed when forming a fist, grasping or gripping things, or turning
What causes deQuervain's Tendinitis
The cause of deQuervain's tendinitis is an
irritation of the tendons at the base of the thumb. For example, awkward hand positions
required by a new mother in caring for an infant is a common cause of this condition.
symptoms of deQuervain's Tendinitis
Pain over the thumb side of the wrist is the
main symptom. The pain may appear either gradually or suddenly. It is felt in the wrist
and can travel up the forearm. The pain is usually worse with use of the hand and thumb,
especially when forcefully grasping things or twisting the wrist. Swelling over the thumb
side of the wrist is noticed and may be accompanied by a fluid-filled cyst in this region.
There may be an occasional "catching" or "snapping" when moving the
thumb. Because of the pain and swelling, it may be difficult to move the thumb and wrist,
such as in pinching. Irritation of the nerve lying on top of the tendon sheath may cause
numbness on the back of the thumb and index finger.
Diagnosis of deQuervain's Tendinitis
A Finkelstein test is generally performed. In
this test, the patient makes a fist with the fingers over the thumb. The wrist is then
bent in the direction of the little finger (Figure 2). This test can be quite painful for
the person with deQuervain's tendinitis. Tenderness directly over the tendons on the
thumb-side of the wrist is the most common finding, however.
The goal is to relieve the pain caused by the
irritation and swelling. In some cases, your doctor may recommend resting the thumb and
wrist by wearing a splint. Anti-inflammatory medication taken by mouth or injected into
that tendon compartment may help reduce the swelling and relieve the pain. In some cases,
simply not doing the activities that cause pain and swelling may allow the symptoms to go
away on their own.
When symptoms are severe or do not improve,
surgery may be recommended. The surgery opens the compartment (covering) to make more room
for the irritated tendons (Figure 3). Normal use of the hand can usually be resumed once
comfort and strength have returned. Your hand surgeon can advise you on the best treatment
for your situation.