De Quervain’s tendinosis

De Quervain’s tendinosis is when the tendons at the base of the thumb, and the tendon sheath (a tunnel like structure through which the tendons pass), swell up causing pain on the side of the wrist nearest the thumb. It can be particularly painful if you’re gripping something or turning your wrist.

Causes

There are a number of reasons why the tendon or tendon sheath swell up, the most common being overuse. It’s also more common if you:

  •     Are lifting young children
  •     Have rheumatoid arthritis
  •     Are a middle-aged woman

Symptoms

These include pain and swelling on the thumb side of the wrist which can travel up the forearm and is usually worse when moving your hand and thumb. It particularly affects people who play sport that involves gripping or twisting, for example tennis or squash and fencing. You may also have a sensation of your thumb ‘catching’ when you move it.

Diagnosed

Your specialist may be able to diagnose the condition by asking you to carry out the ‘Finkelstein test’. This involves making a fist with your fingers over your thumb, then moving your wrist towards your little finger. This may be painful on the thumb side of the wrist.

Treatment

Non-operative treatment: this includes resting the wrist and thumb by wearing a splint. Your specialist may also advise you to take anti-inflammatory medication, along with stopping activities that make your symptoms worse. Some people are also offered steroid injections in the tendon sheath to reduce pain and inflammation.

Surgery: if your symptoms don’t improve, you can sometimes have a procedure to open the thumb compartment; this allows more room for the tendons to move.

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery.

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