De Quervain Tenosynovitis
De Quervain tenosynovitis or de Quervain syndrome is pain accompanied by swelling at the base of the thumb and wrist. This pain is caused by inflammation of the tendon sheath located at the base of the thumb.
Tendons are connective tissue that connects muscles and bones to help the movement of bones. Inflamed tendons will swell and feel pain when moved.
If quickly treated, de Quervain’s tenosynovitis can be cured with drugs and therapy. But in severe cases, patients need to get further treatment to overcome de Quervain’s tenosynovitis.
Symptoms of De Quervain’s Tenosynovitis
De Quervain tenosynovitis is characterized by pain and swelling near the base of the thumb, which can appear gradual or sudden. This pain usually gets worse when moving the thumb or wrist, for example when pinching or grasping.
This condition should be treated quickly. If left unchecked, pain can spread to the arms.
When to see a doctor
Go to a doctor if your thumb and wrist still hurt even if you are not moving it or after it is cold pressed. Patients may need further examination if the pain does not go away even after taking pain medication.
Causes of De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is caused by excessive use of the thumb and wrist. A person can experience de Quervain’s tenosynovitis due to repetitive movements involving the thumb or wrist, such as pinching, squeezing, or clenching.
In some cases, de Quervain’s tenosynovitis is caused by injury to the wrist and arthritis.
De Quervain’s tenosynovitis can occur to anyone, but is more at risk of attacking people who have the following risk factors:
- Aged between 30-50 years.
- Female sex.
- Experience hormonal changes due to pregnancy.
- Having a job or hobby that involves repetitive movements of the thumb and wrist, for example playing tennis or playing games on a smartphone.
Diagnosis of De Quervain’s Tenosynovitis
To determine whether the patient has de Quervain tenosynovitis, the doctor will ask about the symptoms experienced by the patient, then do a physical examination, including pressing the wrist that hurts.
The doctor will also do a Finkelstein test. In this test, the patient will be asked to clench his fist by placing his thumb inside the fist. The clenched fist is then bent towards the little finger. If the base of the thumb feels painful, the patient is strongly suspected of developing de Quervain’s tenosynovitis.
Treatment of De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis treatment aims to reduce pain and inflammation, and restore the ability to move the thumb and wrist. Treatment methods include:
- Provision of pain relievers, such as ibuprofen and naproxen.
- Giving corticosteroid injections in the tendon area, to relieve swelling.
- Installation of splints or splints, to keep the thumb and wrist from moving. This tool needs to be used for 4-6 weeks.
- Surgery on the area that feels pain, if the handling by other means is not successful in dealing with complaints.
To reduce pain, inflammation, and help the healing process, people with de Quervain’s tenosynovitis are encouraged to compress swollen areas with cold compresses, and not to do any movements or activities that trigger pain for a while.
Patients can also ask the therapist for help to teach techniques to use and strengthen the wrist muscles.
If treated early, de Quervain’s tenosynovitis can heal in 4-6 weeks. After the swelling is gone, the thumb and wrist can be used again normally without pain.
Prevention of De Quervain’s Tenosynovitis
De Quervain tenosynovitis can be prevented by not doing repetitive movements on the wrist. However, if work requires you to do the movement, rest your wrist regularly between activities and wear protection or splints on the wrist.