De Quervain disease
De Quervain Disease: What You Need To Know
What is De Quervain disease?
De Quervain disease or De Quervain’s tenosynovitis is an inflammation and swelling of the thumb tendons. That is why there will be pain that makes thumb and wrist movements difficult. The pain may also radiate into the forearm. In this disease, the synovial membrane (the covering sheath) does not produce enough synovial fluid to lubricate tendons. As a result, it leads to irritation of the tendons—causing inflammation and swelling.
What are the causes of De Quervain Disease?
The causes or the risk factors of De Quervain diseases are:
- Chronic overuse of the thumb
- Blunt injury of the thumb
- Occupations or hobbies involving repetitive thumb motion such as carpenter, gardening, gaming, or typing
- Disease conditions like rheumatoid arthritis
- Baby caring, i.e., lifting baby repeatedly
What are the symptoms of De Quervain Disease?
If you have De Quervain disease, you may experience the following symptoms:
- Pain when moving the thumb to make a fist or for other activity
- Tenderness and swelling at the base of the thumb
- Pain, swelling, and tenderness on the thumb side of the wrist
- A sticking, catching, or snapping sensation during thumb motion
- Difficulty moving the thumb and wrist
- Reduced grip or pinch strength
The pain may radiate into the forearm if it goes unchecked.
How to make a diagnosis of De Quervain Disease?
Your doctor will make a diagnosis based on the physical examination of your thumb. He will look for swelling and tenderness.
Next, your doctor will ask you to perform the Finkelstein test. In this test, you will bend your thumb across your palm and place your fingers over your thumb to make a fist. Then, you will move your wrist towards your little finger. If you feel pain performing this test, you have De Quervain disease.
What is the prognosis of De Quervain Disease?
The condition responds to non-surgical treatments such as medications and physical therapy well. If the treatment starts early, you will feel symptom relief within four to six weeks. But if the condition is due to pregnancy, it may persist up till delivery.
What are the treatments of De Quervain Disease?
The doctor will recommend the following:
- Over-the-counter medications like ibuprofen and naproxen to relieve pain and reduce inflammation.
- A splint to immobilize your thumb and wrist that you will wear for two to six weeks.
- Apply ice and heat alternatively to the affected area of the thumb and wrist
- Avoiding repetitive thumb movements
- Avoiding pinching and grasping
- Massage and strengthening exercises to increase the range of thumb and wrist movements. You may also need to see a physical therapist for proper physical therapy.
What are interventional Pain Management options?
- There is inflammtion around the tendon. That is why, steroid injection helps to reduce inflammation and pain.
- Sometimes there is degenerative tendinopathy. That is why, injection of platelet rich plasma with or without hyluronic acid at the site of pain may be useful
What is the surgical treatment?
Non-surgical interventions work in most situations. But in case non-surgical treatments don’t work for you, the doctor will recommend surgery to relieve your tendons of their sheath so that they can move smoothly.