De Quervain's Tenosynovitis

Condition Basics

What is de Quervain's tenosynovitis?

De Quervain's (say "duh-kair-VANZ") tenosynovitis, also called De Quervain's, is a problem that makes the bottom of your thumb and the side of your wrist hurt. When you have de Quervain's, the ropey fiber (tendon) that helps move your thumb away from your fingers becomes swollen.

What causes it?

People can get de Quervain's when they hurt or use the thumb or wrist too much. Common activities that need your wrist and thumb can cause the problem. Some activities that might cause de Quervain's are:

• Wringing out wet clothes.
• Hammering.
• Skiing.
• Knitting.
• Lifting heavy objects such as a jug of milk, taking a frying pan off of the stove, or lifting a baby out of a crib.

If you are pregnant or if you have diabetes or rheumatoid arthritis, you are more likely to get de Quervain's. More women than men have de Quervain's. You can get the disease at any age. Most people who have de Quervain's are women between the ages of 30 and 50.

What are the symptoms?

De Quervain's may cause pain when you twist your wrist. You might also have pain if you grab something between your thumb and fingers. Many people hear a funny sound like a squeak, crackle, snap, or creak when they move the wrist or thumb.

The bottom of the thumb or the side of the wrist might also be sore or swollen. This can make it hard to move your thumb or wrist. The back of the thumb and index finger may also feel numb. Sometimes de Quervain's can cause a small bump on the thumb side of the wrist. If you don't get treatment, the pain can spread up your forearm or down into your thumb.

How is it diagnosed?

Your doctor will check for swelling, tenderness, or numbness around the base of the thumb. There may also be crackling or popping when you move your thumb.

Your doctor may or may not use the Finkelstein test to help diagnose de Quervain's. To do this test, make a fist with your thumb inside. Then bend your wrist outward toward your little finger. If you feel pain on the thumb side of your wrist, then you most likely have de Quervain's.

The Finkelstein test is done to make sure that you do not have a different problem, such as arthritis in the bottom of your thumb or intersection syndrome. Both of these problems affect the same area of the hand and wrist as de Quervain's.

How is de Quervain's tenosynovitis treated?

The goal of treatment for de Quervain's is to relieve the pain and swelling in your thumb and wrist and to restore normal function.

Symptoms often get better in a few weeks with home care. Your doctor may want you to start some gentle stretching exercises once your symptoms are gone.

But if your wrist or thumb still hurts, your doctor might give you a steroid shot. This is injected into the thumb side of your wrist area. Most people feel better after just one shot, but you might need another shot after 4 to 6 weeks if your wrist and thumb still hurt. No more than 3 shots are used.

If your wrist and thumb do not feel better after trying home treatment and getting 3 shots, your doctor might talk to you about surgery.