Management Team

De Quervain’s Tenosynovitis

Overview

De Quervain’s tenosynovitis is an inflammatory condition that affects the tendon sheath at the base of the wrist, restricting the movement of the thumb.

  • Pain at the base of the thumb that sometimes radiates to the forearm or the elbow.
  • Occasional swelling or redness of the wrist.

  • Wrist overuse-led injury.
  • Women are more commonly affected than men.
  • Middle age (40–59 years).
  • Pregnancy and breastfeeding.
  • Rheumatoid arthritis, diabetes, and thyroid disorders.

  • Physical examination for assessing the pain and certain tests, such as asking the patient to make a fist with the thumbs inside and bending it towards the little finger.
  • Ultrasonography to confirm the diagnosis.
  • Magnetic resonance imaging is rarely required.

Non-surgical treatment

The primary aim of the non-surgical treatment is to alleviate pain. These treatment methods include:

  • Anti-inflammatory medication during the initial phase of the condition.
  • Splints to reduce inflammation by resting the affected area (keeping the thumb in an upright position).
  • Applying ice packs to the affected area.
  • Lifestyle modifications.
  • Steroid injections (a maximum of 1–2 injections) to help reduce the symptoms by approximately 50%–80%.

Surgical treatment

  • Surgery is recommended for patients in whom non-surgical treatment options have failed.
  • The minimally invasive surgery can be performed under local or a short general anaesthesia and involves a small 1–2 inch incision at the base of the thumb to release the thickened tendon sheath and relieve the symptoms.
  • Post-surgery care:
  • A pressure dressing is usually applied for 2 weeks following which the sutures are removed.
  • Physical therapy is usually initiated after suture removal and involves mobilisation and strengthening exercises.
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