DeQuervain's tendonitis is inflammation of the tendons which travel on the thumb side of the wrist. In general, the tendons of the wrist and fingers, including the thumb, run through isolated compartments at the level of the wrist. They pass through specific tunnels and in normal circumstances, the tendons glide easily and smoothly when the finger moves. If swelling and inflammation are present, pain and tenderness can develop at the site of the tunnel surrounding the tendons. This type of condition is related to inflammation of the two tendons that pass and reach the top of the thumb. Usually this condition presents with pain and tenderness at the thumb side of the wrist while performing tight gripping or twisting of the wrist.
WHAT ARE THE SIGNS ANDSYMPTOMS OF DEQUERVAIN'S TENDONITIS?
Pain is the main symptom of DeQuervain's tendonitis and can be associated with specific movements or actions performed with the hand. Activities that require pinch and tight
gripping could elicit the pain. Opening a door or jar, or turning the key to start a car could produce the pain. In some cases when the inflammation is severe, pain may be present even with slight movements of the thumb or wrist.
Swelling on the thumb side of the wrist can be seen and cysts could be noticed as well. Also, in some patients, a snapping or clicking sensation is present due to the inflammation and swelling around the tendons. Some superficial nerves, which provide sensation to the thumb skin, can also be irritated by the tendon inflammation.
HOW IS IT DIAGNOSED?
The diagnosis of DeQuervain's tendonitis is mainly clinical. Tenderness and swelling at the thumb side of the wrist are present. Your physician may perform a stress test to diagnose the condition by stretching the tendons that run to the thumb producing pain. X-rays may also be needed to rule out other conditions such as arthritis, fractures (associated with trauma), etc.
WHAT IS THE TREATMENT FOR DEQUERVAIN'S TENDONITIS?
The goal of treatment is to decrease the inflammation and relieve pain. Due to the inflammatory condition, your physician may recommend limiting thumb movement with a splint and anti-inflammatory medication. Other treatment options include an injection with local anesthetic and a steroid at the site of the tendon, and diminishing the activities that produce the pain.
When conservative options do not improve the condition, surgery may be recommended. This consists of opening the compartment producing more room for the tendons. Normal use of the hand can be initiated when the wound iscompletely healed.