Wrist tendonitis, also known as “De Quervain’s tendinosis,” occurs when the tendons around the base of the thumb are irritated or constricted. Tendons are rope-like structures that attach muscle to bone and are covered by a slippery, soft-tissue layer called the “tendon sheath.” The term “tendinosis” specifically refers to a swelling of the tendons and tendon sheath, which can cause pain and tenderness along the thumb side of the wrist, particularly when forming a fist, grasping an object, or turning the wrist. (Ortho Info)

Causes

De Quervain’s tendinosis can be caused by overuse, appearing in patients who perform a variety of repetitive-motion activities such as assembly-line work, weeding, or typing. Carpenters, dentists, office workers and musicians are also examples of patients who are at greater risk of developing this condition.(Health Line)

This condition can also be caused by underlying health conditions including:

• Rheumatoid arthritis
• Scleroderma
• Gout
• Diabetes
• Reiter’s syndrome
• Gonorrhea

In rare cases, tendon inflammation is due to an infection from a cut or puncture to the tendon, or can be attributed to pregnancy. This condition is most common in middle-aged women. (Health Line)

Symptoms

Signs of De Quervain’s tendinosis include:

• Pain over the thumb side of the wrist, appearing gradually or suddenly
• Swelling over the thumb side of the wrist, which may accompany a fluid filled cyst in the region
• A catching or snapping sensation may be felt when moving the thumb
• Joint stiffness in the affected area
• Redness of the skin that overlies the tendon (Health Line)

Doctor Examination

On the patient’s initial visit to MidAmerica’s Palos Hills or Mokena clinic, a physician may perform the Finkelstein test. The patient will be instructed to make a fist with fingers closed over the thumb, then bending the wrist toward towards the little finger. If De Quervain’s tendinosis is present, this test can be quite painful, especially on the thumb side of the wrist. (Ortho Info)

Treatment

The goal of treating De Quervain’s tendinosis is to relieve pain caused by swelling and irritation.

There are numerous nonsurgical treatment options available including:

• Splints - May be used to immobilize the thumb and wrist
• Anti-Inflammatory Medication (NSAIDs) - Your physician may prescribe medications such as ibuprofen or naproxen to relieve short-term pain and to reduce swelling
• Avoid activities that cause pain and swelling - this may allow the symptoms to recede on their own
• Corticosteroid injections - These may help reduce pain in severe cases, but have been proven to weaken the tendon over time. (Ortho Info)

Surgical Treatment

If nonsurgical treatment methods prove ineffective, or symptoms are particularly severe, surgery is an option. Your doctor may recommend De Quervain’s tendon release surgery to reduce pressure on a tendon that runs along the side of the wrist near the thumb. This procedure available at MidAmerica’s Palos Hills and Mokena clinics, involves an incision near the base of the thumb, opening the tissue over the swollen part of the tendon, allowing the tendon to move freely without pain. (MyHealth.Alberta.Ca)

Recovery often involves some degree of soreness and pain, which is a normal part of the healing process. Stitches will be removed 1-2 weeks after surgery, and your doctor may recommend a hand splint for 1-4 weeks after surgery. Most patients heal completely in 6-12 weeks. Most patients who develop sheath inflammation make a full recovery with treatment. (MyHealth.Alberta.Ca)

For specialized care, turn to MidAmerica’s Hand and Upper Extremity Orthopaedic Specialist, Anton J. Fakhouri or Hand and Upper Extremity Surgeon Gary A. Kronen.

To learn more about MidAmerica Orthopaedics and the different De Quervain’s tendinosis treatment options available, visit our website.

To schedule an appointment at MidAmerica’s Palos Hills or Mokena location, with Hand and Upper Extremity Orthopaedic Specialist Anton J. Fakhouri, Hand and Upper Extremity Surgeon Gary A. Kronen, call (708) 237-7200 or request an appointment online. We also serve Chicago, Oak Lawn and Orland Park.