De Quervain’s tenosynovitis is a problem with the tendons on the thumb side of your wrist. Tendons are strong bands of tissue that attach muscle to bone. A sheath, or covering, surrounds the tendons that run from your wrist to your thumb. The tendons usually move easily through this sheath. Tenosynovitis is an irritation and thickening of this sheath that traps the tendons or makes it harder for the tendons to move through the sheath.
What is the cause?
De Quervain’s tenosynovitis is usually caused by overusing your thumb or wrist. This is more likely in activities where you bend your wrist or use your thumb to grip something, like skiing, typing, or construction work. Other causes of this condition include wrist injuries and rheumatoid arthritis.
What are the symptoms?
Symptoms may include:
Pain when you move your thumb or wrist, or make a fist
Swelling and pain on the thumb side of your wrist
Feeling or hearing creaking as you move your thumb or wrist
How is it diagnosed?
Your healthcare provider will examine you and ask about your symptoms, activities, and medical history. You may have X-rays or other scans.
How is it treated?
You will need to stop doing the activities that cause pain until you have healed. Your healthcare provider may give you a splint that covers your wrist and thumb and keeps them from moving. The splint can help relieve your symptoms. If you keep having pain, your provider may give you a shot of a steroid medicine. If these treatments don’t work, you may need surgery to relieve the pain.
Your healthcare provider may recommend exercises to help you heal.
How can I take care of myself?
To help relieve swelling and pain:
Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth, on the area every 3 to 4 hours for up to 20 minutes at a time.
Do ice massage. To do this, first freeze water in a Styrofoam cup, then peel the top of the cup away to expose the ice. Hold the bottom of the cup and rub the ice over your tendon for 5 to 10 minutes. Do this several times a day while you have pain.
Keep your wrist up on pillows when you sit or lie down.
Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Moist heat may help relax your muscles and make it easier to move your hand and wrist. Put moist heat on the injured area for 10 to 15 minutes at a time before exercises. Moist heat includes heat patches or moist heating pads that you can purchase at most drugstores, a wet washcloth or towel that has been heated in the dryer, or a hot shower. Donâ€™t use heat if you have swelling.
Follow your healthcare provider’s instructions, including any exercises recommended by your provider. Ask your provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid, including how much you can lift, and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
How can I help prevent de Quervain’s tenosynovitis?
Warm-up exercises and stretching before activities can help prevent this problem. If your wrist hurts after exercise, putting ice on it may help keep it from getting injured.
Follow safety rules and use any protective equipment recommended for your work or sport.
Avoid activities that overuse your thumb or wrist.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-21 Last reviewed: 2014-10-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
De Quervain’s Tenosynovitis: References
DeLee, Jesse C., David Drez, and Mark D. Miller, Orthopaedic Sports Medicine: Principles and Practice, Saunders; 4th ed. 2014.
Greene, Walter B., M.D., Griffin, Letha Y. (Ed), Essentials of Musculoskeletal Care, 4th ed. Amer Academy of Orthopaedic. 2010.
Kisner, Carol, and Lynn Colby, Therapeutic Exercise: Foundations and Techniques, F. A. Davis Company; 6th ed, 2012.