De Quervain’s disease is a painful inflammation of tendons in the thumb that extends to the wrist (tenosynovitis). The swollen tendons and their coverings rub against the narrow tunnel through which they pass. The result is pain at the base of the thumb that extends into the arm.
Fun fact: This syndrome was named after the Swiss surgeon Fritz de Quervain in 1895.
Other names of De Quervain Syndrome:
It is characterized by chronic wrist pain and swelling, difficulty of grasping, burning sensation on the affected part. It sometimes results in immobility. The pain may be intense when one grasps, grips, turns the wrist, or forms a fist. The condition can occur gradually or suddenly. Some people feel pain if direct pressure is applied to the area.
Although there is no confirmed cause, it is almost always related to overuse of the wrist. Some predisposing factors that are linked to the development of the disease are:
Patients may come in with the chief complaints stated above. An orthopedic specialist then would do an examination. One identifying test for this condition is a positive Finkelstein test, during which the doctor will ask the patient to make a fist with their thumb placed on their palm. If pain is present upon bending the wrist towards the outside, the swollen tendons are pulled through the space and upon stretching. The patient is then confirmed of the disease.
X-rays may be ordered prior to confirming diagnosis to rule out bone involvement like fractures or any other pathology that may be detected. Ultrasound may be done as well to visualize the soft tissue and to see whether there is evident inflammation.
When non-surgical procedures don’t work, surgical procedure is advisable. The goal of surgery is to release tight areas (by opening the dorsal compartment covering) to make more room for the irritated tendons. The opening allows pressure relief of the tendons, to ultimately restore free tendon gliding.
After the procedure, the wrist is splinted in a neutral position until the skin sutures are removed. This will minimize the probability of tendon displacement. The prognosis for permanent recovery is excellent.
If you’re having pain in your thumb as you do the movements as stated above, our orthopedic specialist can evaluate your condition and can advise you of the appropriate treatments for your condition. Click here to book an appointment with our orthopedic specialists.