De Quervain’s Tenosynovitis Treatment
Dr. Pamela Mehta MD
Hand Surgeon in San Jose
Dr. Pamela Mehta is an experienced hand & wrist surgeon renowned for her expertise in sports injuries and joint arthritis. She is the founder of Resilience Orthopedics.
With an impressive career and training under leading innovators, she has served as Chief of Orthopedics and National Orthopedic Director for a major orthopedic hospitalist group and advises several publicly traded companies.
Table of Contents
What is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis is a common wrist condition caused by irritated tendons in your wrist.
It often occurs without a clear cause, though factors such as age and sex can put you at a higher risk of developing it. It can be treated with simple measures such as a splint but sometimes requires hand surgery.
This condition is also sometimes known as de Quervain’s tendonitis. It affects two tendons that pass through a tendon sheath in your wrist at the base of your thumb.
These tendons are surrounded by a slippery layer called the synovium, to protect them from friction. When this becomes swollen and inflamed, it causes pain at the side of your wrist.
You can also suffer difficulty with wrist movements.
Causes
The cause of de Quervain’s tenosynovitis is often unclear. It is sometimes associated with overuse and repetitive wrist movements. Examples of this include gardening, gaming, or playing tennis.
You are at higher risk of de Quervain’s tenosynovitis if you are:
- Aged 30-50, though those in other age groups can still develop de Quervain’s tenosynovitis
- Female – women are up to 10 times more likely to develop it
- Recovering from, or previously had, a wrist injury
- Pregnant, or have just given birth
- Suffering from rheumatoid arthritis
Symptoms
If you have pain or swelling in your wrist and thumb, you might have de Quervain’s tenosynovitis. Pain can come on suddenly or gradually over time. It is felt at the base of your thumb and outside of your wrist – where the inflamed tendons are found.
Symptoms of de Quervain’s tenosynovitis include:
- Pain at the base of your thumb and outer wrist
- Radiating pain that goes up your forearm or into your thumb
- Swelling near the base of your thumb
- Numbness in your thumb and index finger
- Squeaking sounds or a catching sensation when moving your thumb
Book a Consultation with Dr. Pamela Mehta, MD
The Best Orthopedic Surgeon in San Jose
Dr. Mehta is a board-certified orthopedic surgeon who can help you recover from your joint condition.
We can help if you:
- Are Suffering From Pain and Mobility Issues
- Need Orthopedic Assessment and Advice
- Want Treatment From a Top Orthopedic Doctor
Call On 408-559-3888
or Send a Message
Diagnosis
When you see Dr. Mehta, she will examine your wrist and thumb. She will locate the site of discomfort and check if certain movements cause pain. She will determine possible causes of pain and decide whether you need any further tests.
Usually, joint pain requires an x-ray to help rule out alternative diagnoses. This could include conditions such as:
- Osteoarthritis of the first carpometacarpal joint
- Scaphoid or radial styloid fracture
- Wartenberg’s syndrome
- Intersection syndrome
- Trigger thumb
If you have no red flag symptoms and all the signs of tenosynovitis are present, this may not be necessary.
De Quervain’s Tenosynovitis vs Carpal Tunnel Syndrome
Carpal tunnel syndrome tends to cause symptoms in your palm, thumb, and first two fingers. This differs from de Quervain’s tenosynovitis, which gives symptoms in the wrist and base of your thumb.
An orthopedic specialist, such as Dr. Pamela Mehta, can differentiate between the two conditions. They will carefully assess your symptoms and order relevant tests.
Treatment
Treatment for de Quervain’s tenosynovitis usually conservative (simple) treatments. The aim of treatment is to reduce inflammation and irritation of your tendon sheath.
Simple measures to help with the pain and swelling include:
- Resting your thumb
- Avoiding painful movements
- Taking anti-inflammatory medications
- Placing an ice pack on your wrist
- Gently massaging your wrist
Splints, Braces, and Physical Therapy
Splints can often be bought from a pharmacy, though it’s important that you get a splint that fits well.
Sometimes special exercises can help you recover from de Quervain’s tenosynovitis. It is important that this is supervised by a physical therapist to avoid making things worse.
Dr. Mehta can advise you on whether stretching or exercises will help or harm your symptoms.
Cortisone Injection
Normally, symptoms improve after 4-6 weeks with treatment. If your symptoms are more severe, or aren’t improving with a brace or splint, Dr. Mehta might recommend a cortisone injection.
Cortisone, a type of steroid, is injected into the tendon sheath which is irritated, reducing inflammation and swelling. This relieves the pain in over half of cases.
Surgery
If your symptoms continue, you may require hand surgery. This is known as de Quervain’s tenosynovitis release or decompression. The procedure opens the tendon sheath in your wrist to make room for the irritated tendons. This can generally be done under a local anesthetic.
Recovery from surgery is usually quick, with pain from your irritated tendons subsiding within the first few days. Physical therapy is often used to help in your recovery from surgery.
You will have a small scar on your wrist which might remain sore for a few weeks after the operation.
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What Hand & Wrist Services Do We Offer?
Hand & Wrist Pain Assessment
We use our hands every day of our lives for some of the most important of life's activities. Hand and wrist pain can be debilitating, meaning you struggle to drive, write, and play sports.
Hand & Wrist Surgery
If your hand condition is severe, or nothing you have tried has helped, Dr. Mehta can advise you on the options for surgery. She is a hand surgeon and can offer expert opinion and care.
Treatment of Hand & Wrist Conditions
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome causes pain and numbness in your hand, and sometimes requires surgery.
De Quervain's Tenosynovitis
De Quervain's Tenosynovitis causes swelling and pain at the base of your thumb.
Wrist Bursitis
Wrist bursitis can cause pain and stiffness if your wrist. Treatment is often non-surgical.
Trigger Finger
Dr. Mehta is experienced in trigger finger injection and release surgeries.
Dr. Mehta offers diagnosis and treatment of all hand & wrist conditions and can offer her specialist opinion as an expert hand doctor.
Call Us On 408-559-3888
or Send a Message