De Quervain’s tendinitis is a condition brought on by the irritation or inflammation of the wrist tendons at the base of the thumb. The inflammation causes a constriction of the tendons as they travel through a tight tunnel in the wrist, creating pain with thumb and wrist movement.
Overuse is the primary cause of De Quervain’s tendinitis. The tendons at the base of the thumb become irritated by repetitive activity such as texting. People who have suffered a wrist fracture or injury to the tendon can be predisposed to develop this condition, as are women during the post-partum period. It is also associated with inflammatory conditions such as rheumatoid arthritis.
The main symptom is pain felt over the thumb side of the wrist that appears gradually or suddenly. The pain can travel up the forearm or down through the thumb. Making a fist, pinching, grasping or twisting objects are common painful movements with this condition. There may be swelling over the thumb side of the wrist which may include a fluid-filled cyst. There may also be numbness on the back of the thumb and the index finger. There may be a “snapping” sensation when moving the thumb.
Depending on the severity of the condition, physicians will try non-surgical approaches to relieve the pain caused by irritation and swelling. Splints may be used to rest the thumb and wrist. Anti-inflammatory medications (NSAIDs) may help reduce pain. Activity modification to avoid motions that cause pain may be recommended. If the symptoms persist, an injection of corticosteroids into the tendon sheath may help relieve the condition.
If the symptoms are severe or do not improve with non-operative treatment, surgery to open the thumb compartment to make more room for the irritated tendons may be recommended.
Consult with a fellowship-trained hand surgeon if you are experiencing pain in your thumb or wrist.