By Michael G. Soojian, M.D., Hand & Upper Extremity Surgeon
What is De Quervain’s Tendonitis?
If you are experiencing a shooting pain from your wrist into your thumb, you may be suffering from a common form of tendonitis called de Quervain’s tendonitis. This condition gets its name from Dr Fritz de Quervain who first described it in 1895, and is often referred to by other names such as texting thumb, gamer’s thumb, and mother’s wrist. Anatomically, two separate tendons start in the forearm and pass through a small sheath or tunnel as they cross the wrist, before they attach to the thumb. Repetitive movements can cause these tendons to experience friction and lead to a build-up of inflammation within this sheath, which manifests as pain, swelling and a feeling of weakness with routine daily activities.
Causes of Quervain’s Tendonitis
This condition usually occurs as a result of repetitive gripping and lifting, and other activities such as swinging a hammer, using a cell phone, working in the yard or even carrying a baby. Less commonly, this problem can result from trauma, i.e. a direct blow or a sudden yank to the hand or wrist.
DeQuervain’s tendonitis can usually be diagnosed by physical examination which can detect swelling and tenderness over the tendon sheath. Many patients feel as though their “bone is sticking out” but in actuality it is a thickening of the soft tissue sheath they are feeling. X-rays can be taken to rule out other sources of pain, but in most cases end up being normal.
Will De Quervain’s Go Away on its Own?
In its early stages, DeQuervain’s tendonitis can often be successfully treated with bracing and oral anti-inflammatories such as ibuprofen. Occupational/Hand Therapy can also help some patients. When these simple treatment options fail to provide relief, cortisone injection is usually recommended and can cure this problem about 75% of the time. When all else fails, a minor surgery can decompress the tendons and definitively treat the problem. This surgery entails a brief trip to the operating room and is performed under local anesthesia that is usually combined with an intravenous sedative (“twilight anesthesia”). After the surgery, the hand and wrist are wrapped in a soft bandage for a few days and routine activities are encouraged. The majority of the symptoms usually resolve within two weeks, and most patients are pain free within four to six weeks.
