DeQuervain’s was named after the Swiss surgeon who described this condition back in 1895. DeQuervain’s tenosynovitis describes the painful swelling and inflammation of the tendons of the thumb. As a result, the tendon cannot glide inside their sheath easily anymore, causing pain and difficulty in certain movements.
Risk factors that can precipitate DeQuervain’s include the following:
• Female sex: women are 10 times more likely to develop this condition.
• Repetitive use of the thumb
• Activities that include frequent grasping, such as lifting young children, gardening, certain sports, etc.
Symptoms usually include pain in the side of the wrist and hand, that may be precipitated by a certain activity and at times can be debilitating.
History and physical exam are usually enough to confirm the diagnosis. Your doctor will typically perform the Finkelstein test. This involves making a fist with the thumb wrapped around the fingers. Moving the wrist up and down in that position typically reproduces the symptoms of DeQuervain’s.
The first line of treatment is commonly a trial of conservative management. This may include:
• Rest
• Splinting
• Icing
• NSAIDS
• Steroid injection in the tendon sheath
If conservative treatment fails, the next option is surgery, which is performed in a day-case basis, under local anaesthetic. A small incision is made on top of the tendon and a small cut performed in the tendon sheath. This usually allows the tendon to move freely. You will have a small dressing for a few days. A hand therapy home exercise program will be given to you after the procedure.
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