De Quervain’s tendinitis

Description

A tendon is thick bendable tissue that connects muscle to bone. Two tendons run from the back of your thumb down the side of your wrist. De Quervain’s tendinitis is caused when these tendons are swollen and irritated.

More about Your Injury

The constant lifting of children can put strain on the tendons in the wrist. De Quervain’s tendonitis can also be caused by sports such as tennis, golf, or rowing .

If you have De Quervain’s tendinitis, you may notice:

  • Pain on the back of your thumb when you make a fist, grab something, or turn your wrist
  • Numbness in the thumb and index finger
  • Swelling of the wrist
  • Stiffness when moving your thumb or wrist

What to Expect

De Quervain’s tendinitis is usually treated with rest, splints, certain medicines, changes in activities, and exercises.

In some cases, your doctor may give you a shot of a medicine called “cortisone.” This medicine can help decrease pain and swelling.

If your tendinitis is a chronic injury, you may need surgery. This surgery will give the tendon more room to slide without rubbing on the tunnel wall.

Symptom Relief

Ice your wrist for 20 minutes of every hour while awake. Do not apply ice directly to the skin.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medications at the store.

  • Talk with your health care provider before using these medications if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past
  • Do not take more than the amount recommended on the bottle or by your health care provider.

Activity

The best therapy is to rest your wrist. Keep your wrist immobile for at least 1 week. You can do this with a wrist splint.

Wear a wrist splint during any sports or activities that could put stress on your wrist.

Once you can move your wrist without pain, you can start light stretching to increase strength and movement.

Your doctor may recommend a physical therapist who will work with you so that you can return to normal activity as soon as possible.

To increase strength and flexibility, do light stretching exercises. One exercise you can practice is squeezing a tennis ball:

  • Hold your hand out in front of you.
  • Lightly grasp a tennis ball.
  • Gently squeeze the tennis ball, then add more pressure if there is no pain or discomfort.
  • Hold for 5 seconds, then release your grip.
  • Repeat 5 - 10 times. Do this a few times a day.

Before and after:

  • Use a heating pad on your wrist to warm the area up.
  • Massage the area around your wrist and thumb to loosen the muscles.
  • Ice your wrist and take pain medication after activity if there is any discomfort.

The best way for the tendons to heal is to stick to a care plan. The more you rest and practice exercises, the quicker your injury will heal.

When to Call the Doctor

Follow-up with your healthcare provider if:

  • The pain is not improving or becomes worse 
  • Your wrist becomes more stiff
  • You have increasing numbness or tingling in the wrist and fingers or if they turn white or blue

References

O'Neill CJ. de Quervain tenosynovitis. In: Frontera: Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 4.


Review Date: 6/19/2012
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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