De Quervain’s Tenosynovitis Symptoms, Causes & Treatment Options

De Quervain’s tenosynovitis is a condition in which the tendons of the hand become inflamed. The inflammation of the tends of the hand can cause pain and keep the hand and the wrist from functioning properly. It is caused most frequently by repeated motion, is most common in women, and is treated through injections or in some cases through surgery.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is De Quervain’s Tenosynovitis?

Summary

De Quervain’s tenosynovitis is a disorder caused primarily by compression of the tendons that are affected. As they become swollen, the tendons become irritated, and that swelling can cause pain and trap the tendons. It is thought to be caused by repetitive motion injury and is more common among women. It is common among women in middle age and is in some cases thought to be associated with either trauma or an injury to the affected area, or the stress on joints caused by repeatedly lifting infants.

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De Quervain’s Tenosynovitis Symptoms

Main symptoms

The symptoms of de Quervain’s tenosynovitis are caused by swelling and compression of the tendons of the area that is affected. Normally, tendons move smoothly within their sheaths, but if they are damaged, swollen, or inflamed through repeated use or another process, they can catch within their sheaths, swell, and cause significant pain and loss of function.

  • Joint swelling: Because de Quervain’s tenosynovitis involves inflammation, depending on the tendons involved, de Quervain’s may cause swelling of the wrist and pain with movement of the wrist.
  • Thumb pain: Frequently, the tendons of the thumb are affected in de Quervain’s tenosynovitis. Depending on which part of the tendon is affected, you may experience pain when grasping something, turning your wrist, or making a fist.
  • Popping joints: If the tendon is inflamed or the joint capsule is inflamed, as the tendon moves, it may catch and release within the joint causing popping or clicking sensations.
  • Stiffness: Swelling of the tendons of the thumb can cause stiffness. When inflammation is present, the spaces of the tendon can fill with inflammatory fluid and that fluid can make it difficult to articulate ore move the joint.
  • Redness: One of the hallmarks of inflammation is redness. In de Quervain’s tenosynovitis, there may be redness around the affected area or redness in a line tracking upward along the length of the affected tendon. Redness along the length of the tendon is often related to the cause of the inflammation and may be a sign of infection.

De Quervain’s Tenosynovitis Causes

The primary causes of de Quervain’s tenosynovitis are overuse and excessive strain. The connective tissue that surrounds the thumb can become inflamed over time and repeated use. In the past, de Quervain’s tenosynovitis has been associated with motherhood because of the hand motions that are necessary to continually care for an infant. In other cases, de Quervain’s tenosynovitis can be associated with other causes of inflammation like an inflammatory condition (e.g., rheumatoid arthritis, lupus)

Repetitive stress/overuse

The tendons that usually are involved in de Quervain’s tenosynovitis run underneath a band of connective tissue at the wrist. Because of this, repetitive motions that involve flexing those tendons and rubbing them across the sheath, like pinching and turning (as might be necessary to feed a small item to an infant, place a pacifier, or turn a key) can inflame the connective tissue around the tendon.

  • Repetitive “key turning” motions
  • Tennis
  • Golf
  • Professions or hobbies involving pincer grip manipulation
  • Lifting a child into a car seat

Inflammatory condition

Rheumatoid arthritis and lupus are conditions that cause inflammation in the body. They can affect the joints, and it is not uncommon for these conditions to cause joint pain and even de Quervain’s tenosynovitis. If de Quervain’s tenosynovitis is caused by an inflammatory disease, then proper treatment involves reducing inflammation from the underlying disease. Additionally, conditions not thought of as inflammatory conditions, like pregnancy, can also predispose individuals toward de Quervain’s tenosynovitis. It is unclear whether this is related to hormones or inflammation.

  • Rheumatoid arthritis
  • Lupus
  • Pregnancy

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Treatment Options, Relief, and Prevention for De Quervain’s Tenosynovitis

Treatment

The treatment of de Quervain’s tenosynovitis depends on the original cause. Generally, the underlying cause should be treated, and damage to the tendon, the sheath surrounding the tendon, or the overlying structures should be treated and allowed to heal. Pain relief is usually achieved using over-the-counter pain medications like acetaminophen or ibuprofen if you are able to tolerate it. It is also possible to use ice to numb the area. Before using any pain control treatment, consult the instructions and do not take more than intended and be careful not to apply ice outside of an ice pack to avoid damage to the skin from excessive cold.

De Quervain’s tenosynovitis that stems from an inflammatory condition is usually best controlled by treating the underlying inflammatory condition. This can be done using disease-modifying anti-inflammatory drugs or steroids to suppress the immune response and inflammation. If you have an inflammatory disease, you should seek treatment by a healthcare provider. If the inflammation stems from repetitive motion, it is important to stop any motions that aggravate the inflammation and begin to engage in stretching of the tendon.

Finally, treatment of the underlying cause of the inflammation is the first step. The damage that is caused by inflammation should also be allowed to heal. This may mean limiting activity for a week at a time using a splint. A splint can be applied by a health care professional or picked up over the course of time. Once the pain has disappeared, it is important to stretch the ligaments and strengthen the muscles.

Prevention

De Quervain’s tenosynovitis can be avoided if it caused by a particular behavior. Common ways to avoid tenosynovitis caused by sports is by stretching the ligaments and tendons that are used in the activity before and after practice or performance. If tenosynovitis is caused by inflammation or inflammatory diseases, continuing to take modulatory medications can prevent flares that can cause de Quervain’s. If de Quervain’s tenosynovitis is caused by lifting a child or a particular physical action, that action should be modified to decrease the stress placed on the tendon or ligament.

When to Seek Further Consultation for De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is not lethal and does not affect the ability of the hand to move permanently. However, it should improve with treatment. If your de Quervain’s tenosynovitis is not improving or is accompanied by other symptoms like cough, cold, illness, or body pain, you should seek further evaluation.