De Quervain’s Tenosynovitis

Wrist/hand

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a painful condition that affects the tendons at the base of your thumb. These tendons, the abductor pollicis longus and the extensor pollicis brevis, aid in motion and grip of the thumb. When the sheath around these tendons becomes swollen and inflamed, it compresses the tendon, causing the characteristic pain and limited range of motion associated with De Quervain’s tenosynovitis.

What are the Symptoms?

The most common symptoms of De Quervain’s tenosynovitis include:

Pain: This is the primary symptom, usually felt at the base of the thumb towards the wrist. The pain may be aggravated by activities that involve gripping or pinching.
Tenderness: The area around the base of the thumb may be tender to the touch.
Swelling: Slight swelling near the base of the thumb may be noticeable.
Catching or snapping sensation: Some people may feel a catching or snapping sensation when moving the thumb
Decreased grip strength: Difficulty grasping objects due to pain and weakness in the thumb.

What are the Causes & Risk Factor?

The exact cause of De Quervain’s tenosynovitis is not fully understood, but several factors are believed to contribute to its development:

Repetitive thumb and wrist movements: Activities that involve repetitive grasping, pinching, or forceful thumb movements can overuse and irritate the tendon, leading to inflammation. Examples include greasing tools, using vibrating power tools, or frequent texting.
Recent childbirth and breastfeeding: Hormonal changes during pregnancy and breastfeeding can contribute to fluid retention, which can affect the synovial sheath around the tendon and increase the risk of de Quervain's tenosynovitis.
Direct trauma: A sprain or injury to the wrist or thumb can sometimes lead to inflammation of the tendon and surrounding tissues.
Certain medical conditions: Rheumatoid arthritis and other inflammatory conditions can increase the risk of developing de Quervain's tenosynovitis.

Predisposing factors of De Quervain's Tenosynovitis

Certain factors can increase your risk of de Quervain’s tenosynovitis:

Occupations: People whose jobs require repetitive motion of the thumb and wrist, such as carpenters, musicians, or assembly line workers, are more prone to this condition.
Recent childbirth and breastfeeding: Hormonal changes during this period can increase the risk.
Age: De Quervain’s tenosynovitis is more common in middle-aged adults, especially women.
Previous wrist or thumb injury: A sprain or fracture in the wrist or thumb can make you more susceptible to De Quervain’s tenosynovitis.

Diagnosis of hip osteoarthritis

The diagnosis of De Quervain’s tenosynovitis usually includes:

Physical examination:

A health care professional will examine your wrist and thumb. They will palpate the area to identify the location of the tenderness and assess the intensity of the pain.

Finkelstein's test:

This specific test involves making a fist by tucking the thumb inside the fingers and then turning the wrist toward the little finger. This position stretches the tendon and can reproduce pain if de Quervain’s tenosynovitis is present.

Imaging tests:

X-rays: X-rays can help identify bone abnormalities in the wrist or thumb, but they don’t directly see soft tissues like tendons.

Treatment options for hip osteoarthritis

Treatment for De Quervain’s tenosynovitis focuses on reducing inflammation, relieving pain, and preventing further injury. Here’s an overview of common treatment options:

Rest: Avoiding activities that aggravate pain, especially those that involve forceful gripping or pinching, is crucial for early healing.
Splinting: Wearing a thumb and wrist immobilizing splint or thumb brace can help reduce inflammation and prevent further stress on the tendon.
Ice therapy: Applying an ice pack to the affected area for 15-20 minutes at a time, several times a day can help reduce pain and inflammation.
Anti-inflammatory medications: Over-the-counter pain relievers (ibuprofen, acetaminophen) or prescription medications can be used to manage pain and swelling.

Physical therapy:

Physical therapy can play an important role in the management of de Quervain’s tenosynovitis.
Pain management techniques: Strategies such as ultrasound therapy or electrical stimulation can be used to manage pain and inflammation in some cases.
Corticosteroid injections: In some cases, injecting corticosteroids directly into the area around the tendon can relieve pain and significantly reduce inflammation. However, repeated injections are not recommended due to possible side effects.

Surgery:

Surgery for De Quervain’s tenosynovitis is rarely necessary and is usually only considered if conservative treatment fails to provide significant improvement after a long period of time (usually several months). Here is the most common surgical procedure:
Tenosynovectomy: This outpatient surgery involves releasing the tough ligament sheath around the tendon at the base of the thumb, creating more room for the tendon to slide more easily and reducing friction

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