DeQuervain's Tendonitis

DeQuervain's Tendonitis is caused by irritation and swelling of the tendons along the thumb side of the wrist. The irritation causes the tendon to swell, making it difficult for the tendons to move normally within the tendon sheath. The pain usually occurs when forming a first, gripping or lifting objects, or rotating the writs.

Symptoms

Pain over the thumb side of the wrist is common. The onset of pain may be either gradual or sudden. The pain can radiate up the forearm. The pain is worse when using the thumb, especially when lifting heavy objects. Swelling over the thumb side of the wrist may be associated with a fluid-filled cyst in this region. There may be an occasional "snapping" when moving the thumb. It may be difficult to move the thumb and wrist with pinching or grasping activities. Irritation of the nerve lying on top of the tendon sheath may cause numbness on the back of the thumb and index finger.

Treatment Options

Conservative treatment such as rest and avoiding activities that cause pain and swelling may allow the symptoms to resolve over time in some patients. If the symptoms continue, the pain may be alleviated by resting the thumb and wrist in a splint for a few weeks. Over-the-counter anti-inflammatory medication may also help. If these conservative measures are ineffective a cortisone injection into the tendon sheath may reduce swelling and relieve pain.

Surgery

When symptoms are severe or do not improve with conservative treatment, surgery may be recommended.

Surgery involves an incision in the tendon sheath to relieve pressure on the irritated tendon. Surgery can be done on an outpatient basis.

After surgery the wrist is kept in a splint for 2 weeks. Normal use of the hand can usually be resumed once comfort and strength have returned.