DeQuervain's Tenosynovitis (D-quare-vanes T-no-sigh-no-vie-tis)The condition is named after Fritz de Quervain, a Swiss surgeon. DeQuervain's Tenosynovitis is an inflammation of the synovial tissue that covers the tendons that straighten and pull the thumb away from the hand (hitchhiker position). The tendons involved are the ones along the thumb side of the wrist that are prominent when the thumb is extended away from the hand. The indentation formed between these two tendons is known as the Thenar Snuffbox. Inflammation of the tendons or of the tissue that surrounds them, causes swelling and restricts the tendons' ability to glide back and forth to move the thumb.
Chronic overuse of your wrist is commonly associated with de Quervain's tenosynovitis.
When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons normally glide unhampered through the small tunnel that connects them to the base of the thumb. If you repeat a particular motion day after day, it may irritate the sheath around the two tendons, causing thickening that restricts the movement of the tendons.
Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons
Inflammatory arthritis, such as rheumatoid arthritis
- Pain along the thumb side of wrist most common.
- May radiate down to the end of the thumb or up along the thumb side of the forearm.
- Pain is most commonly felt when reaching the thumb across the palm or when (bending) the wrist and turning it towards the little finger (ulnar deviation).
- Pain may also be felt when pressure is applied over the tendons that run along the outside of the thumb and wrist.
- Direct injury to your wrist or tendon
- scar tissue can restrict movement of the tendons
- Inflammatory arthritis, such as rheumatoid arthritis
- People between the ages of 30 and 50 have a higher risk of developing de Quervain's tenosynovitis than do those in other age groups.
- The condition is more common in women than in men, and it may be associated with pregnancy.
- Baby care, which involves using your thumbs as leverage to lift your child hundreds of times a day, may also be associated with the condition.
- Jobs or hobbies that involve repetitive hand and wrist motions may contribute to de Quervain's tenosynovitis as well.
To diagnose de Quervain's tenosynovitis, we will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist. We will also perform a test called the Finkelstein test. In a Finkelstein test, you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain's tenosynovitis.
Imaging tests, such as X-rays, generally aren't needed to diagnose de Quervain's tenosynovitis.
When to see a doctor
Consult your doctor if you're still having problems with pain or function and you've already tried:
- Avoiding moving your thumb in the same way over and over again whenever possible
- Avoiding pinching with your thumb when moving your wrist from side to side
- Applying cold to the affected area
- If the pain continues to interfere with your daily life or activities, seek medical advice.
Dr. Berry's Class IV Treatment Program
The Class IV K-Laser is at the heart of our treatment program. It provides a safe, effective, non-invasive, painless solution for DeQuevain's. Patients respond exceptionally well to treatments and usually notice significant pain relief after just a few treatments.
Dr. Berry's program utilizes the latest FDA Cleared Lasers, and combines them with other therapies to help reduce the pain, strengthen the muscles and increase range of motion. Most importantly these treatments help reduce inflammation/swelling, which helps improve overall function. Dr. Berry has been treating sports injuries for over 35 years and has been helping people suffering from various health conditions during that time.
Patients seek his advice and care if they want to avoid surgery if at all possible and help you return to all the activities you enjoy.