Dr Steve Carter
De Quervains Tendinitis
This is the most common tendinitis in the wrist and presents with pain at the base of the thumb. It is caused by inflammation in the tendon sheath of the two tendons running from the thumb namely Abductor Pollicis Longus and Extensor Pollicis Brevis.
- The exact cause of the tendinitis is not known, but it is associated with repetitive activities.
- It is more common in women than men. Often seen in young mothers, perhaps related to picking up the young baby or child.
- It is diagnosed by clinical examination and the so called Finkelstein’s test, where the thumb is placed in the palm of the hand thereby stretching the trapped tendons. Beware this can be very painful.
- Treatment is aimed at reducing the inflammation and freeing up the tendons.
- It is certainly a condition that is amenable to splinting.
Our first line of treatment is a cortisone injection into the first dorsal compartment to relieve the inflammation. If this is done early ie less than 6 weeks following the onset of symptoms we have a 80% success rate. If the cortisone fails to work or the patient presents late, a surgical release of the tendon sheath is performed. This is done via a small 1cm incision and is curative.