De Quervain's Tenosynovitis

This information describes the causes, symptoms, and treatment of de Quervain’s tenosynovitis (da-cur-vains teno-sin-o-vitis).

Figure 1. Wrist with De Quervain's tenosynovitis

De Quervain’s tenosynovitis is a common and painful condition that affects the tendons of the wrist. A tendon sheath (protective covering) wraps around these tendons so that they can slide easily (see Figure 1). This allows you to turn your wrist, grip, and pinch with your hand. With de Quervain’s tenosynovitis, the tendon sheath becomes swollen. This causes pain and limited movement in your wrist and thumb.

Causes of De Quervain’s Tenosynovitis

Some causes of de Quervain’s tenosynovitis include:

  • Overuse of the wrist with repetitive movements, such as:
    • Typing
    • Knitting
    • Using a hammer
    • Holding an infant for a long time
    • Carrying heavy grocery bags
  • Strain or injury to the wrist area.
  • Conditions that cause swelling throughout the body, such as rheumatoid arthritis.

 

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Symptoms of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis can cause different symptoms, such as:

  • Pain at the side of your wrist under the base of your thumb. Moving your thumb can increase this pain.
  • Wrist pain that has spread into your forearm and thumb.
  • Mild swelling, redness, or warmth at your wrist.
  • A fluid-filled cyst near the thumb side of your wrist.

Your doctor can see if you have de Quervain’s tenosynovitis based on your symptoms and a physical exam. They will also ask you to do certain movements with your hand, wrist, and thumb.

Most people don’t need x-rays of the area, but your doctor will let you know if you do.

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Treatment for De Quervain’s Tenosynovitis

The goals of treatment are to:

  • Reduce pain and swelling.
  • Maintain normal joint function.
  • Prevent the condition from returning.

Depending on your symptoms, your doctor may recommend:

  • Avoiding the following:
    • Activities that cause pain in your thumb and wrist.
    • Repetitive thumb and wrist movements, such as typing and hammering.
    • Pinching while moving your wrist.
  • A splint to keep your thumb and wrist still.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve your pain and inflammation, such as:
    • Ibuprofen (Advil®, Motrin®)
    • Naproxen (Aleve®, Naprosyn®)
    • Celecoxib (Celebrex®)
    • Meloxicam (Mobic®)
    • Diclofenac (Voltaren®)
      • NSAIDS may cause side effects. Ask your doctor if they are safe for you to take.
  • Steroid injections (shots) into your wrist to decrease pain and swelling.
  • Applying ice or heat to your wrist. Your doctor or nurse will tell you which one to use.
    • When using heat:
      • Fill a water bottle with warm water and place it on your wrist. You may also use a heating pad. Make sure that the water bottle or heating pad isn’t too hot before putting it on your wrist.
      • Apply it for 15 minutes every 4 to 6 hours.
      • Don’t leave the water bottle or heating pad on for more than 15 minutes at a time.
    • When using ice:
      • Apply an ice pack for 20 minutes every 4 to 6 hours.
  • Treatment with an occupational or physical therapist to:
    • Help you do your daily activities while wearing a splint.
    • Show you how to adjust your home and work activities to ease the stress on your wrist.
    • Teach you exercises to strengthen your arm, wrist, and hand while you recover.
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