DeQuervain Tenosynovitis

What is DeQuervain Tenosynovitis?
  • DeQuervain Tenosynovitis is the inflammation of the tendons (the cords that attach muscle to bone) that extend the thumb as they pass under a broad ligament structure at the base of the thumb/wrist.
  • This inflammation can cause pain along the edge of the thumb and at the wrist when the thumb is pulled back into the hitch-hiking position.
  • It can also be painful when the thumb is bent into the palm, when the wrist is moved from side to side,  or when using a twisting motion such as when wringing out a washcloth.
  • Common Symptoms
    • Pain at the base of the thumb and the thumb side of the wrist.
    • Swelling and tenderness where the thumb meets the wrist.
    • Pain with thumb movement and activity.

Common Treatments may include:
  • Use of a wrist brace, splint or orthotic at night to immobilize the thumb and allow the swollen tendon to heal;  Use of a wrist brace, splint or orthotic as needed during painful activity during the day to provide support and stability.
  • Implementing Ergonomic Improvements & Activity Modification
    • Perform activities with the wrist in as neutral a position as possible (wrist flat and not angled to one side or the other).
    • Avoid repetitive or sustained pinch or grasp of larger objects of objects.
    • Limit texting or smart phone activity;  or modify by laying the phone or tablet flat on the table and using the index or middle fingers to type rather than holding the phone in a cupped hand and moving the thumb over the screen.
  • Use of Heat and cold 
    • Use cold packs for acute pain or swelling.
    • Use heat packs to control more chronic pain or relax the muscles.
  • Wearing compression or Isotoner gloves at night may help control swelling and provide a comforting, neutral warmth.
  • Perform gentle thumb motion and the radial nerve gliding exercise. 
  • Use of topical pain relieving creams if helpful and as needed.
  • Modalities such as ultrasound, electrical stimulation and iontophoresis may be helpful to reduce pain and inflammation.
  • Therapeutic taping may be helpful to reduce pain and provide gentle support.
  • A short course of anti-inflammatory medications, such as NSAIDs, may be helpful as prescribed by an MD or over-the-counter (Advil, Aleve) if not contraindicated by other medical conditions.
  • A Cortisone injection at the site of the inflamed tendon may help to reduce inflammation.
  • If conservative treatment methods do not alleviate the symptoms, surgical options may be considered.

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