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.
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.
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.