De Quervain’s Tenosynovitis is a painful condition that affects two tendons on the thumb side of your wrist. These tendons are located in a narrow space, almost like a tunnel. When the tendons become inflamed, they rub against the sides of the “tunnel”, causing pain and swelling. Keep reading to find out the symptoms, diagnosis, and treatment of De Quervain’s Tenosynovitis.
Symptoms of De Quervain’s Tenosynovitis
De Quervain’s Tenosynovitis is characterized by pain in the base of the thumb when you make a fist, pinch or grasp. You may have difficulty moving your thumb at all, and have a generally reduced range-of-motion. Sometimes, in bad cases, you can see fluid or swelling in the area of the tendons. Without proper treatment, the pain can worsen or spread.
De Quervain’s Tenosynovitis is typically caused by repetitive activity, not a one-time traumatic event. It’s most commonly seen in people who work in factories and have a repetitive type job, or in athletes that do repetitive motions. It’s most observed in women ages 30-50, and can be caused by repeatedly lifting your child.
Diagnosing De Quervain’s Tenosynovitis
Diagnosis of De Quervain’s Tenosynovitis occurs through a physical exam. The key physical test is the Finkelstein test. This test is performed by moving the thumb into the palm of the hand, then flexing the wrist at the same time. If it is a positive test, it will produce pain at the thumb and wrist area. In addition, X-rays are typically performed at the doctors office to rule out any significant arthritis in the area.
Treating De Quervain’s Tenosynovitis
Treatment involves immobilization of the area with a brace or cast. The use of an oral, nonsteroidal anti-inflammatory medication is okay, if allowed by your health care provider. It should be noted that Tylenol will not help the problem. A cortisone injection in the area of inflammation is another option.
Instead of a cortisone shot, a PRP injection can also be given. The PRP is a natural way to reduce the inflammation, pain and swelling. PRP is made by drawing some blood from your arm. The blood is spun in an in-office centrifuge. This process separates the plasma and platelets from the rest of the blood cells. The platelet rich plasma (PRP) is then injected into the area of the inflammation. It can take 6-8 weeks of treatment to have resolution of all the symptoms.
Physical therapy can also be useful to help reduce the inflammation. If all conservative treatment fails, there is a surgery to open up the tight tunnel where the tendons are located. This procedure takes the pressure off the inflamed tendons.
If you are struggling with symptoms of De Quervain’s Syndrome, Orthopaedic Specialists can help! To schedule an appointment with Dr. Grossfeld and the other experts at Orthopaedic Specialists, call 502-212-2663 today.