DeQuervain’s Tenosynovitis

This is a condition where the tendons the move the thumb base are irritable in a tunnel the runs on the thumb side of the wrist. 

What are the causes?

It is not entirely clear what causes the tendons and tunnel to become painful. It is not an inflammation as was originally thought, but a degenerative process.  It is more common in women and in middle age.  The pain is thought to be due to an increased pressure within the tunnel which impedes movement.  

What are the symptoms?

Patients can present with pain over the thumb side of the wrist when moving the thumb to the side.  This can settle on spontaneously in the early stages.  Pain can be worse when trying to lift the affected thumb away from the palm.  

How is it diagnosed?

Clinical examination is often all that is needed to make a diagnosis. An X-ray can be useful to look for other causes of pain such as arthritis.

How is it treated?

Many patients can be treated without surgery, but persistent disabling symptoms may need this. Hand therapy and relative rest with a splint is the first step. An ultrasound guided injection of steroid may be beneficial.

If symptoms persist the tunnel can be released surgically. This is known as a DeQuervain’s release.