What Are the Treatments for De Quervain's Tenosynovitis?

De Quervain's tenosynovitis is a condition in which the tendons on the side of the wrist at the base of the thumb become inflamed. This inflammation restricts movement of the tendons. The condition causes pain and swelling when turning your wrist or grasping an object. Medications and, in severe cases, surgery may be needed to treat de Quervain's tenosynovitis.

Causes

• There are two major tendons in your wrist and thumb that come into play when you grasp or grip an object. These tendons run in a small tunnel from the forearm to the base of the thumb and normally glide naturally. Chronic overuse of the tendons will cause inflammation and restriction of movement. Lifting heavy objects can strain muscles and tendons, such as lifting a child, grocery bags or lifting objects at your job.

Symptoms

• Symptoms of de Quervain's tenosynovitis include pain and swelling at the base of your thumb, a fluid-filled cyst located where the pain originates, difficulty moving the thumb or wrist, and numbness in the back of the thumb and index finger. Pinching, grasping and gripping will aggravate pain in the wrist and thumb area.

Conservative Treatment

• Your doctor may start treatment by immobilizing your wrist and thumb allowing the tendons to heal. A splint or brace may be used to keep them straight. Over-the-counter medications such as Motrin or Advil can reduce inflammation and alleviate pain. Apply heat for stiffness and cold packs for swelling to help tendons to heal. When OTC medications do not help pain, your doctor may prescribe corticosteroid injections. These injections are administered at the location of the pain and should reduce inflammation quickly.

Therapy

• Your doctor may recommend a physical therapist if severe de Quervain's tenosynovitis is diagnosed. A physical therapist can recommend ways to reduce stress on your wrists and exercises designed to strengthen muscles surrounding your wrist and to reduce pain and swelling.

Surgery

• When conservative measures do not help, surgery may be an option. In the procedure, the surgeon will check the sheath surrounding the tendons that are inflamed and will open the sheath to reduce pressure and allow more space. Recovery time should take four to six weeks.

Prevention/Solution

• Avoid repetitive hand and wrist movements as much as possible. When your job requires these kinds of movements, adjust the way you move your wrist each day so different tendons will be used in your daily routine.