Dr Steve Carter
De Quervains Tendinitis
What is De Quervain's tendinitis?
De Quervain's tenosynovitis is a type of tendinitis that causes pain at the base of the thumb on the radial aspect of the wrist due to swelling and inflammation in the two extensor tendons running from the thumb. When these tendons are swollen, the tendon sheath becomes inflamed, causing severe pain when moving the thumb or wrist.
Though a direct cause of de Quervain's is unknown, it can be the result of repetitive activities that involve wrist movements. Because the condition mostly affects women, it is also believed that actions such as lifting and carrying babies can also be a cause of de Quervain's. The condition is also known as “Mommy's” thumb.
De Quervain's tenosynovitis is the most common type of tendonitis in the wrist. It can affect all age groups and often occurs after starting a new repetitive activity like knitting or a new gym routine or exercise. The condition is characterised by pain and swelling at the base of the thumb that leaves grasping or pinching difficult to achieve. Affected patients may also experience a sticking sensation when moving their thumbs too.
How is De Quervain's tendinitisis treated
If left untreated, de Quervain's tenosynovitis can cause severe pain that can eventually spread down the arm and prevent patients from having full, comfortable use of their hands. That's why it is important to treat the condition before it gets worse.
De Quervain's tenosynovitis is diagnosed by a clinical examination and the Finkelstein's test. During this test, the thumb is placed in the palm of the hand to stretching the trapped tendons. Though this test can be very painful, it is an important step to diagnosing the condition and finding the correct treatment.
When treating de Quervain's, Dr Carter will attempt to reduce the inflammation in the wrist and free up the tendons. Though early signs of inflammation can be relieved with a cortisone injection in the affected area, a surgical procedure may be needed if this doesn’t work or if the condition is very severe. This same-day procedure is usually performed under local anaesthetic and takes about 30 minutes to complete.
During the surgical procedure, Dr Carter will make a 1cm incision in the wrist to open the tendon sheath and help relieve the pressure in the affected area. This is a curative procedure, and the recurrence rate is extremely low. Patients can expect a full recovery within 4 weeks of the surgery.