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De Quervain tendinitis

Tendinopathy - De Quervain tendinitis; de Quervain tenosynovitis

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Description

A tendon is thick, bendable tissue that connects muscle to bone. Two tendons run from the back of your thumb down the side of your wrist. De Quervain tendinitis is caused when these tendons are swollen and irritated.

More About Your Injury

De Quervain tendinitis can be caused by playing sports such as tennis, golf, or rowing. Constantly lifting babies and toddlers can also strain the tendons in the wrist and lead to this condition.

If you have De Quervain tendinitis, you may notice:

• Pain on the back of your thumb when you make a fist, grab something, or turn your wrist
• Numbness in the thumb and index finger
• Swelling of the wrist
• Stiffness when moving your thumb or wrist
• Popping of the wrist tendons
• Difficulty pinching things with your thumb

What to Expect

De Quervain tendinitis is usually treated with rest, splints, medicine, changes in activity, and exercise. Your doctor may also give you a shot of cortisone to help decrease pain and swelling.

If your tendinitis is chronic, you may need surgery to give the tendon more room to slide without rubbing on the wall of the tunnel that guides it.

Symptom Relief

Ice your wrist for 20 minutes of every hour while awake. Wrap the ice in cloth. Do not put ice directly on the skin because this can result in frostbite.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

• Talk with your health care provider before using these drugs if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or by your provider.

Activity

Rest your wrist and your thumb. Keep your wrist from moving for at least 1 week. You can do this with a wrist splint.

Wear a wrist splint during any sports or activities that could put stress on your wrist.

Once you can move your wrist without pain, you can start light stretching to increase strength and movement.

Your provider may recommend physical therapy so that you can return to normal activity as soon as possible.

To increase strength and flexibility, do light stretching exercises. One exercise is squeezing a tennis ball.

• Lightly grasp a tennis ball.
• Gently squeeze the ball and add more pressure if there is no pain or discomfort.
• Hold for 5 seconds, then release your grip.
• Repeat 5 to 10 times.
• Do this a few times a day.

Before and after any activity:

• Use a heating pad on your wrist to warm the area.
• Massage the area around your wrist and thumb to loosen the muscles.
• Ice your wrist and take pain medicine after activity if there is discomfort.

The best way for the tendons to heal is to stick to a care plan. The more you rest and do the exercises, the quicker your wrist will heal.

When to Call the Doctor

Follow up with your provider if:

• The pain is not improving or becomes worse
• Your wrist becomes more stiff
• You have increasing numbness or tingling in the wrist and fingers, or if they turn white or blue

References

Donahoe KW, Fishman FG, Swigart CR. Hand and wrist pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Kelly and Firestein's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 53.

O'Neill CJ. de Quervain tenosynovitis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 28.

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Review Date: 6/8/2022  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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