If you experience pain in the part of your wrist closest to your thumb, you may have a condition known as De Quervain's Tenosynovitis. This condition causes pain and discomfort when twisting and turning the wrist or when making a grabbing fist motion. While the exact cause of De Quervain's Tenosynovitis is unknown, there are many ways to treat and manage this painful condition. Keep reading to learn more about the causes and cures for De Quervain's Tenosynovitis.
Also known as De Quervain's Stenosing Tenosynovitis or Blackberry thumb, this condition results from inflammation or compression of the tendons at the base of the thumb.
Normally, the two tendons in the wrist and lower thumb slide effortlessly through a tunnel that connects to the thumb base. In people with De Quervain's Tenosynovitis, the exterior (or sheath) of these tendons can thicken and swell. Over time, this leads to pain and restricted movement.
De Quervain's Tenosynovitis Causes
Although the exact mechanism underlying De Quervain's Tenosynovitis is not known, it is related to:
Long-term overuse of the wrist, especially when exercising or using a computer mouse
Repetitive motions such as gripping, clenching, or wringing
Rheumatoid arthritis, a form of inflammatory arthritis
Physical trauma to the wrist that results in scar tissue
You are more likely to get De Quervain's Tenosynovitis if one or more of the following apply:
You are between 30 and 50 years of age
You are a woman (the condition affects women up to ten times more than men)
You are pregnant
You look after a baby, as repeatedly lifting children can cause undue pressure on the thumbs and tendons in the wrist
You engage in activities that involve repetitive strain on the wrist and hand
De Quervain's Tenosynovitis Symptoms
The primary symptom associated with De Quervain's Tenosynovitis is pain at the base of the thumb. The condition can also cause:
Swelling around the base of the thumb
Limited ability to move the thumb and wrist, especially when grabbing or pinching an object
A lack of fluidity in the thumb’s movement (a sensation that the thumb is getting stuck)
Untreated De Quervain's Tenosynovitis can lead to the spread of pain up through the thumb, or into the forearm. Long term, it may impact your range of motion and hand dexterity.
In addition to asking about your symptoms, a doctor will often use the De Quervain's Tenosynovitis test to make a diagnosis. Also known as the Finkelstein test, it involves:
Bending the thumb across the palm and closing the fingers over the thumb.
Then, bending the wrist toward the little finger to cause a stretch in the wrist near the base of the thumb.
If you experience pain when carrying out this test, you most likely have De Quervain's Tenosynovitis.
De Quervain's Tenosynovitis Treatment
There are many ways to treat De Quervain's Tenosynovitis using home remedies and medical interventions. Each treatment aims to quell inflammation, maintain and improve movement in the thumb, and prevent further damage or recurrence of the condition.
Most people see the greatest benefits when they employ several treatment options, so we always recommend working with your doctor to figure out the best combination for your needs. Some treatment options you may wish to consider include:
As De Quervain's Tenosynovitis is linked to repetitive movement, rest is one of the easiest ways to both prevent and treat the condition. Resting the hand involves:
Avoiding repetitive movements of the wrists and thumbs.
Avoiding excessive pinching or wringing motions.
Avoiding activities that put strain on the thumbs, such as lifting children.
Noting any activities that increase pain and swelling and telling your doctor about these actions.
When you notice pain or inflammation, apply a cold compress to the thumb and wrist. Or, better yet, use an ice pack specially constructed for treating injuries.
You can use cold therapy several times a day following the onset of symptoms. Ice can also be applied to prevent pain and swelling following tennis, golf, and other activities that put strain on the wrists.
De Quervain's Tenosynovitis Exercises
When it comes to De Quervain's tenosynovitis, stretching and strengthening exercises are essential. The following exercises are known to help those with De Quervain's tenosynovitis:
Begin by holdingg your arm out straight in front of you, with the palm facing downward and the elbow locked. Take your opposite hand and use it to pull your fingers toward you, so the palm is facing away from your body. Hold for 30 seconds. Repeat three times.
Hold your arm out straight in front of you, palm upward, with your elbow locked. With your opposite hand, pull your fingers toward you, so the palm is facing away from your body. You should feel a stretch through your forearm. Hold for up to 30 seconds. Repeat three times.
Grip Strengthening Exercises
Use a grip strengthener or some therapy putty to strengthen the muscles in the hand, wrist, and arm. Squeeze your hands around the hand gripper or putty, holding the squeeze for five seconds. Repeat this fifteen times, doing two sets of fifteen repetitions daily.
De Quervain's Tenosynovitis Splint
The best thumb splints are a great way to support your aching digit without sacrificing comfort. ( See Product on Amazon )
Using a thumb splint or other hand support device is an important step in treating this condition. A good thumb splint provides support to the thumb joint, limits its range of motion, and reduces pain and swelling.
Try a quality wrist brace to ensure maximum support and stability for your joint. ( See Product on Amazon )
A wrist brace goes one step further than a thumb splint—it immobilizes both the thumb and the wrist so your hand can enjoy some high-level support. Braces not only control the wrist’s range of motion, they also ensure proper anatomical alignment which can encourage a speedier recovery.
Treating with physical therapy is another option that proves effective for many. Your physical therapist may recommend one or more of the following:
Using a splint or brace like those mentioned above
Altering the way you use your wrist
Making adjustments to your lifestyle to reduce stress on the wrists and thumb
A program of exercises to stretch and strengthen the muscles while relieving pain and swelling
Treating Associated Conditions
If you have a condition that is linked to De Quervain's Tenosynovitis, treating that condition may reduce your symptoms. For example, you can treat rheumatoid arthritis with medications, an anti-inflammatory diet, specific arthritis exercises, and a pain-relieving arthritis cream.
Your doctor may recommend over-the-counter pain relievers such as ibuprofen (Advil or Motrin IB) and naproxen (Aleve) if your pain and swelling are significant. To ensure you never miss a dose, store your medications in a handy pill organizer.
More severe cases may require a De Quervain's Tenosynovitis injection, or corticosteroid injection. This medication is injected directly into the inflamed tendon to stop pain. For some people, just one shot is enough to resolve symptoms completely.
De Quervain's Tenosynovitis Surgery
When other treatments do not work, or for extremely serious cases of De Quervain's Tenosynovitis, surgery may be the only option.
This type of surgery is carried out on an outpatient basis, meaning you can go home shortly after the procedure. It involves opening the damaged tendon sheath to release any pressure that is inside. The tendons should then glide easily through the tunnel to the thumb.
Recovery from De Quervain’s Tenosynovitis
The length of time it takes to recover from De Quervain's Tenosynovitis depends on many factors including:
How long you had the condition before seeking treatment
The severity of the symptoms
Treatment techniques used
Your general health and mobility
If you use a wrist brace and follow the treatment plan laid out by your doctor and physical therapist, you may recover in as little as four to six weeks. Some people get better even sooner, although people who delay treatment can expect longer recovery times.
Similarly, surgery recovery time varies from person to person. Those who follow their post-surgery exercise program may recover quicker than those who don’t.
Finding Relief from De Quervain’s Tenosynovitis
De Quervain’s Tenosynovitis is usually treatable, especially if you act fast and follow your treatment program closely. For the best chance of a quick recovery, be sure to rest your hand whenever possible, provide it with additional supports such as a thumb brace or splint, and engage in regular massage and hand exercises. Remember, many of these techniques can be used preventatively to ensure you never have to deal with the pain of De Quervain’s Tenosynovitis.
Jessica Hegg is the content manager at ViveHealth.com. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle. Through her writing she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.
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