De Quervain's Tenosynovitis

8/17/2018 in Medical Conditions

De Quervain’s Tenosynovitis is an inflammation of tendons and their sheaths on the side of the wrist at the base of the thumb.  It can be brought on by a simple strain injury, but is often the result of repetitive motion injury.  Some causes can be occupational in nature, but also the result of video gaming, lifting young children into car seats, lifting heavy grocery bags by the loops or lifting gardening pots up into place.  De Quervain’s Tenosynovitis can also be caused by a direct blow to the wrist or tendon. 

Risk factors include the following:

  • Age – those between the ages of 30-50 have a higher risk
  • Sex – the condition is more common in women
  • Pregnancy (typically appears 4-6 weeks after delivery)
  • Jobs or hobbies that involve repetitive hand and wrist motions

De Quervain’s tenosynovitis symptoms include a feeling of sharp or dull pain, swelling, and tenderness at the side of the wrist beneath the base of the thumb.  It is typically diagnosed based on typical appearance, location of pain and tenderness.  It can also be diagnosed if pain is experienced when the Finkelstein maneuver is performed.  To do this, bend the thumb down across the palm of the hand and then cover the thumb with the fingers.  Next, bend the wrist toward the little finger.   Lab tests or diagnostic imaging is not required.

Treatment is geared at relieving symptoms such as a splint to stop moving the thumb and wrist, Tylenol or other anti-inflammatory medications, cortisone-type of steroid injection into the tendon compartment.  If these options are not provided relief, surgery to open the tunnel and make more room for the tendons may be considered. 

The results of a recent study suggest in a proportion of participants De Quervain’s tenosynovitis could be secondary to underlying wrist pathology due to previous trauma.  So, if the claimant isn’t reporting a  history of repetitive strain, then the treating physician could be asked to conduct a more thorough assessment to establish if there is any underlying pathology. 

In conclusion, De Quervain’s Tenosynovitis is a temporary condition that generally responds well to treatment.  However, if the condition isn’t treated, it can permanently limit range of motion or cause the tendon sheath to burst.

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