De Quervain’s Synovitis is a painful condition affecting the thumb-side of the wrist. It is caused by the inflammation of the extensor tendons of the thumb. Tendons are bands of tissue that attaches muscles to bones. There are two extensor tendons attached to the thumb and during straightening of the thumb, these tendons slides through the tissue that covers it (sheath). Due to repetitive and forceful movements, the tendons in the thumb may become inflamed. When this happens, it swells up and take up more space than usual within the narrow space of the sheath, causing pain.
- Pain felt over the thumb-side of the wrist, which can radiate up the forearm
- A painful bump (nodule) at the thumb-side of the wrist
- Clicking sensation when straightening the thumb
- Repetitive extension of the thumb
- Other existing conditions: rheumatoid arthritis, pregnancy
Treatment for de Quervain’s tenosynovitis is aimed to reduce inflammation and to allow you to regain the normal function in your thumb and wrist. For mild cases, the surgeon might recommend resting the wrist with a splint. Physiotherapy sessions may help with range-of-motion exercises to improve your posture, flexibility and also to strengthen the muscles affected.
For pain management, the surgeon may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and also to reduce inflammation of the tendons. In more severe cases, corticosteroids may be prescribed orally or through injection directly into the tendon sheath.
Surgery is usually recommended for more serious or chronic cases. The surgery is aimed to create more room for the tendon to move through the sheath. This is achieved by cutting the sheath open to release the pressure.