The disease affects the tendons on the thumb side of the wrist, resulting in swelling and pain. It is also known as De Quervain Tenosynovitis, De Quervain Syndrome, or Washerwoman's Sprain.
The exact cause of de Quervain’s is not known, but it may be related to:
Repetitive hand or wrist movements, such as typing, gardening, or lifting a baby
Inflammatory arthritis, such as rheumatoid arthritis
Direct injury to the wrist or tendon, which may cause scar tissue that restricts movement of the tendons
Fluid retention, such as from changes in hormones during pregnancy
The main symptom of de Quervain’s is pain near the base of the thumb, which may spread to the forearm. The pain may worsen when you turn your wrist, grasp anything, or make a fist. You may also experience:
Swelling near the base of the thumb
Difficulty moving the thumb and wrist
A “sticking” or “stop-and-go” sensation in the thumb when moving it
A squeaking sound when moving the thumb and wrist
Your doctor will examine your hand and wrist and ask you about your symptoms and activities in order to diagnose Quervain's. Performing the Finkelstein test, in which you bend your thumb across the palm of your hand and bend your fingers down over it, may be asked of you. When your wrist bends toward your little finger, you may have de Quervain's if it causes pain on the thumb side.
Imaging tests, such as X-rays, are usually not needed to diagnose de Quervain’s, unless your doctor suspects another condition, such as a fracture or arthritis.
The treatment for de Quervain’s aims to reduce inflammation, preserve movement in the thumb and wrist, and prevent recurrence. The treatment may include:
Resting the thumb and wrist and avoiding activities that trigger pain
Applying ice to the affected area for 15 to 20 minutes several times a day
Taking over-the-counter pain relievers, such as ibuprofen or naproxen
Wearing a splint or brace to immobilize the thumb and wrist and allow the tendons to heal
Doing gentle exercises to stretch and strengthen the muscles and tendons of the hand and wrist
Getting corticosteroid injections into the tendon sheath to reduce swelling and pain
Having surgery to release the tendon sheath and make more room for the tendons to glide freely
The treatment may vary depending on the severity of your condition, your response to conservative measures, and your personal preferences. Your doctor will discuss the best treatment options for you and the possible risks and benefits of each option.
To prevent de Quervain’s, you can:
Avoid repetitive hand or wrist movements or change the way you do them
Take frequent breaks from activities that strain the thumb and wrist
Use ergonomic tools and equipment that fit your hand and wrist size and shape
Warm up before doing any strenuous activity that involves the hand and wrist
Stretch and massage the hand and wrist regularly
Seek medical attention if you have any signs or symptoms of de Quervain’s
De Quervain’s is a common and treatable condition that can affect anyone, especially those who use their hands and wrists a lot. By following the above tips, you can reduce your risk of developing de Quervain’s and improve your quality of life.
