Don’t Let De Quervain’s Tendonitis Sneak Up on You

Injuries caused by repetitive hand movements are nothing new. Some medical institutions are reporting a rise in repetitive movent hand injury diagnoses. Carpal tunnel syndrome is widely known and understood as a condition that occurs when the median nerve in the wrist is pinched. But carpal tunnel has a lesser-known cousin that can be just as painful.

De Quervain’s Tendonitis was once referred to as Washer Woman Sprain. Named after the Swiss surgeon Fritz de Quervain, the syndrome is a form of tendonitis that often affects new moms, childcare providers, court reporters, computer programmers, pro athletes, construction workers, and others who exert their wrists repeatedly over long periods. People with De Quervain’s commonly describe pain when moving their thumbs, making a fist, or grasping something. And now, the condition is also referred to as Gamer’s Thumb because videogame play is a repetitive task that can negatively affect hand and wrist health.

Wrist Tendonitis is a Call for Attention

Unlike carpal tunnel, De Quervain’s is a condition of the tendon rather than the nerve. Tendons are tough, band-like connective tissues that tether muscle to bone. When tendons are strained by prolonged repetitive motion, they can become inflamed and thickened. Swelling of the tendon can result in an accumulation of fluid, known as tendonitis.

We don’t fully know what causes De Quervain’s. However, we do know it is worsened by chronic overuse of the wrist tendon. People with metabolic disorders like diabetes and rheumatoid arthritis tend to be at a higher risk of developing De Quervain’s Tendonitis.

If you regularly experience pain or tenderness on the thumb-side of your wrist and forearm, you should make an appointment with a certified hand and wrist specialist. Your doctor will conduct a few simple in-clinic tests to determine the extent of your case and rule out other conditions.

If you are diagnosed with De Quervain’s, your doctor will focus on remedies to ease swelling, which is the source of pain. Typically patients with De Quervain’s will be treated with a steroid injection. Often, the wrist is immobilized with a splint or brace for several weeks. Over-the-counter anti-inflammatory drugs such as ibuprofen or naproxen are recommended as well. Additionally, alternating applications of ice and heat can provide short-term pain relief.

When De Quervain’s Tenosynovitis Surgery is Your Best Option

“When conservative management of De Quervain’s syndrome fails, surgery is indicated,” says Dr. Amin Afsari, D.O., and hand and wrist specialist. “Surgical release of the tendons has been shown to provide excellent long-term relief for this condition.”

If surgery is necessary, you can expect an outpatient procedure. Your surgeon will make a small incision in your wrist to release or disconnect the area of the tendon that wraps around the base of your thumb. When the swollen tissue surgically moved out of the way, the tendon can move smoothly, without causing pain. Typically, patients recover from this surgery in six to eight weeks, depending on their occupation. Some patients can return to work with a splint within days. You may need to take a medical leave of absence from work for the first week following surgery.

The good news is that you can mitigate your chances of developing a repetitive motion condition like De Quervain’s by identifying hand and wrist overuse, taking breaks, and regularly exercising to maintain strength and flexibility. Awareness of how you treat your hands and wrists can make all the difference.