Thumb-Side Wrist Pain? It Might Be De Quervain’s Tenosynovitis

If you’re experiencing pain, tenderness, and sometimes swelling on the thumb side of your wrist, especially when gripping, twisting, or lifting things, it’s worth learning about DeQuervain’s tenosynovitis. This common, yet often misdiagnosed condition might be the culprit. Let’s delve into what causes DeQuervain’s, how to recognize it, and the range of treatment options available. Typical Patient and Presentation While DeQuervain’s can affect anyone, here’s the ‘classic’ scenario:

  • New Moms: Hormonal changes, repetitive lifting and caring for a baby puts strain on the tendons.
  • Individuals with Repetitive Hand Use: Hobbies like gardening, racquet sports, and jobs involving forceful gripping motions increase the risk.
  • Middle-Aged & Older: Degenerative changes in the tendons can make them more susceptible to inflammation, even without excessive overuse.

Typical Symptoms:

  • Pain at the Base of the Thumb & Outer Wrist: Aggravated by pinching, grasping, and twisting.
  • Swelling & Tenderness: Sometimes a visible bump develops over the inflamed tendons.
  • Catching or Snapping Sensation: As the condition progresses.
  • Difficulty with Activities: Even tasks like unscrewing a jar, turning a doorknob, or buttoning a shirt can become painful.

What is DeQuervain’s Tenosynovitis (and Why Does It Hurt)?

  • The Culprit: Two tendons that help extend your thumb travel through a tunnel on the thumb side of your wrist. In DeQuervain’s, this tunnel gets thickened, and the tendons become inflamed.
  • The Problem: The inflamed tendons have less room to move smoothly within the tight tunnel, causing pain, swelling, and sometimes a feeling of ‘catching’.

Diagnosing DeQuervain’s Tenosynovitis If I suspect DeQuervain’s tenosynovitis, here’s how I approach diagnosis:

  • Thorough Examination: I’ll assess your wrist and hand motion, look for localized tenderness, and perform specific tests, like the Finkelstein’s test, to reproduce your symptoms.
  • Medical History: Discussing your activities and any recent changes in hand use is important.
  • Imaging: Usually not necessary, but in some cases, an ultrasound or MRI may be ordered to rule out other causes of wrist pain.

Treatment Options: From Conservative to Surgical The good news is that DeQuervain’s tenosynovitis usually responds well to treatment. Here’s the general approach:

  • Nonsurgical Management:
  • Rest & Activity Modification: Avoiding or finding alternative ways of doing the movements that trigger your pain is crucial.
  • Splinting: Immobilizing the thumb and wrist reduces inflammation and gives tendons a chance to ‘calm down’.
  • Anti-inflammatory Medications: Both over-the-counter and prescription medications can help control pain and swelling.
  • Cortisone Injection: A powerful way to directly reduce inflammation in the tendon tunnel. Often provides significant, though sometimes temporary relief.
  • Surgery: Reserved for cases where nonsurgical measures haven’t worked, symptoms are severe, or DeQuervain’s keeps recurring.
  • DeQuervain’s Release: This surgery involves releasing (opening) the thickened tunnel, giving the tendons the space they need to move freely again. It’s usually a quick, outpatient procedure with a high success rate.

Key Takeaway: While DeQuervain’s Tenosynovitis can be frustrating, a range of effective treatments exist. The key is getting an accurate diagnosis and finding the approach that works best for you. My Expertise I specialise in diagnosing and treating DeQuervain’s tenosynovitis. I understand the impact this condition can have on your daily life and work closely with you to find individualised solutions. Whether through conservative therapies or minimally invasive surgical techniques, my goal is to get you back to pain-free hand function. [Embedded YouTube Video (Examples could include patient testimonials, surgeons explaining the procedure, or animations visualizing the condition)] [Speaker Deck Slides] Summary Don’t let thumb-side wrist pain limit your life! If you suspect De Quervain’s tenosynovitis, schedule a consultation so we can discuss a personalized treatment plan to get you back to doing the things you enjoy. Disclaimer The information provided in this blog is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for diagnosis, treatment recommendations, and any questions related to a medical condition. The author, contributors, and publisher of this blog shall not be liable for any direct or indirect losses or damages related to the use of the information presented herein.

Meet Alistair Phillips, Your Orthopaedic Hand and Trauma Surgeon

Ali Phillips is a fellowship-trained hand surgeon dedicated to educating and empowering his patients. He believes in clear information and shared decision-making. When not in the clinic, you might find him wing foiling or on a cycling adventure. Connect: alistairphillips.co.uk @ali.thehandsurgeon on IG, Twitter/X, Threads, FB and TikTok