De Quervain’s Tenosynovitis is an inflammation of the tendon sheaths on the thumb-side of the wrist. It is usually caused by repetitive wrist and thumb actions.
The tendons (which attach muscle to bone) of extensor pollicis brevis (EPB) and abductor pollicis longus (APL) run from the thumb down the wrist and attach to the muscles in the forearm.
These tendons are wrapped in slippery sheaths which help to provide frictionless movement of the thumb and wrist. They do this by allowing the tendons to slide easily through the compartment that holds the tendons in place.
- De Quervain’s is an overuse syndrome. It occurs when the tendon sheaths of two tendons in the wrist become irritated and inflamed. The sheaths swell, causing pain and difficulty of movement.
- De Quervain’s can be caused by repetitive wrist action.
What do I feel?
- Pain on the thumb-side of the wrist. This pain may spread up the forearm or into the thumb.
- Swelling near the base of the thumb.
- Painful thumb and/or wrist movements.
- Squeaking/clicking of the painful area during movement.
What can I do?
- Rest – refrain from doing the repetitive actions which cause the pain.
- Protect the thumb by wearing a splint.
- Do not avoid movement completely or the wrist may stiffen up – take the splint off every so often and do some gentle, pain free wrist and thumb movements.
- Ice may help with the pain.
- Take anti-inflammatory medications regularly as prescribed by your health professional.
- Engage in an active rehabilitation program with a physiotherapist.
The rehabilitation of de Quervain’s tenosynovitis can take four to six weeks. Once the initial pain starts to decrease, a rehabilitation program can commence. This usually includes strengthening exercises and stretches. It is important to commit to your rehabilitation programme in order to prevent chronic injury that may require surgery.