De Quervain’s Tenosynovitis Syndrome, Causes, Diagnosis, Treatment, Prevention, Complications

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De Quervain's tenosynovitis or de Quervain syndrome is pain accompanied by swelling at the base of the thumb and wrist. This pain is caused by inflammation of the tendon sheath at the base of the thumb.

Tendons are tissues that connect muscles and bones to help move the limbs. Inflamed tendons will swell and be painful to move.

If treated quickly, de Quervain's tenosynovitis can be cured with medication and therapy. However, in severe cases, patients need to get further treatment, such as surgery.

Causes of De Quervain's Tenosynovitis

De Quervain's tenosynovitis is caused by overuse of the thumb and wrist. A person can get de Quervain's tenosynovitis from performing repetitive movements of the thumb or wrist, such as pinching, squeezing, or clenching the hand.

In some cases, de Quervain's tenosynovitis is caused by injury to the wrist and inflammatory arthritis.

De Quervain's tenosynovitis can happen to anyone, but it's more common in people who have the following risk factors:

Between 30–50 years old
Female gender
Experiencing hormonal changes due to pregnancy
Have a job or hobby that involves repetitive movements of the thumb and wrist, for example playing tennis or playing games on a smartphone

Symptoms of De Quervain's Tenosynovitis

De Quervain's tenosynovitis is characterized by pain and swelling near the base of the thumb. This pain can appear gradually or suddenly.

In addition, this pain can also get worse when moving the thumb or wrist, for example when pinching or grasping. This condition should be treated quickly. If left unchecked, the pain can radiate to the arm.

When to go to the doctor

Check with your doctor if your thumb and wrist still hurt even when you're not moving or after applying cold compresses. You may need further tests if the pain does not go away despite taking pain medication.

Diagnosis of De Quervain's Tenosynovitis

To determine whether a patient has de Quervain's tenosynovitis, the doctor will ask about the patient's symptoms. After that, the doctor will perform a physical examination, including by pressing the wrist that hurts.

The doctor will also perform a Finkelstein test. In this test, the patient will be asked to make a fist by placing his thumb inside the fist. The clenched hand was then bent towards the little finger. If the base of the thumb is painful, the patient is suspected of having de Quervain's tenosynovitis.

Treatment of De Quervain's Tenosynovitis

Treatment of de Quervain's tenosynovitis aims to reduce pain and inflammation, and restore the ability to move the thumb and wrist. Treatment methods include:

Giving pain relievers, such as ibuprofen or naproxen
Giving corticosteroid injections directly in the tendon area, to relieve swelling
A splint or splint for 4–6 weeks, to keep the thumb and wrist from moving
Surgery on the area that feels pain if treatment by other means doesn't work

To reduce pain and inflammation, as well as help the healing process, patients are advised to compress the swollen area with a cold compress, and not to do any movement or activity that triggers pain for a while.

Patients can also enlist the help of a therapist to teach techniques to use and strengthen the wrist muscles.

If treated early, de Quervain's tenosynovitis resolves in 4–6 weeks. After the swelling is gone, the thumb and wrist can be used normally again without any pain.

Complications of De Quervain's Tenosynovitis

If left untreated, de Quervain's Tenosynovitis will make it difficult for the sufferer to move the thumb and wrist so that daily activities are limited.

Apart from the complications of the condition, there are several complications that can arise if the patient undergoes surgery, namely:

Injury to the thumb nerve (radial nerve)
Pinched muscles around the base of the thumb
Changes in position or displacement of tendons

Prevention of De Quervain's Tenosynovitis

De Quervain's tenosynovitis can be prevented by not performing repetitive movements of the wrist.

However, if work requires you to perform these movements, rest your wrist periodically between activities and wear a wrist protector or splint.

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