De Quervain’s tenosynovitis – Pain In Thumb Side Of Wrist

ByNicolas Rito

Various underlying health conditions can cause pain in your thumb. Figuring out what’s causing the pain might depend on which part of your thumb is hurting and how often you feel it. If it is at the thumb side of the wrist it might indicate that you are suffering from De Quervain’s tenosynovitis.
Treatment for thumb pains depends on the cause, but painkillers and physical therapy is the go-to solution.
In some cases, recurring pain in your thumb might show the need for treatment for another underlying health condition. Those conditions might include direct injury to the thumb or basal joint arthritis or even carpal tunnel syndrome.
Apart from that, an aching thumb joint implies injuries to ligaments at the lower side of your hand and wrist. We suggest you keep reading to find out more about pain on or near your thumb.
The most common type of inflammation-causing thumb pain is radial styloid tenosynovitis. It is also called de Quervain’s tendinosis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis).

What is De Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a painful swelling that affects the tendons of your wrist on the thumb side. It occurs when the tendons at the base of your thumb are irritated or swollen. (de Quervain’s tenosynovitis).
Feeling pain even when gaming?
This condition is also called “gamer’s thumb” sometimes as it can occur due to holding a video game controller for a long time.
If you play games for too long, you might have a gamer’s thumb too. Although its proper name is de Quervain’s tenosynovitis, you could also hear it termed de Quervain’s syndrome.

What does it have to do with swelling?

The word “tendinosis” means the swelling of the tendons of the thumb. Swelling of the tendons, and the sheath covering tendons, can cause pain and tenderness around the thumb and the wrist at the same side.

What causes De Quervain’s tendinosis?

De Quervain’s tendinosis can arise due to many reasons, such as;

  • Overuse
  • Repetitive grasping
  • Inflammatory conditions
  • Accidents
  • Ongoing health conditions

The swollen tendons cause the covering sheaths to become inflamed, due to which they rub against the narrow tissue wall they pass through.
It puts pressure on the base joint of your thumb, causing pain and numbness into the lower arm also.
Although the doctors don’t know the exact cause, it is still believed that it is caused by repetitive hand or wrist movement activities. Such as using tools in the garden, playing with a racket or golf stick, or even lifting your baby can make it worse.

How to diagnose De Quervain’s tendinosis?

The pain caused due to De Quervain’s tendinosis may develop over time or even start swiftly.
When this happens, you may lose the strength to move your thumb and wrist normally.
You may also experience the pain getting worse when forming a fist, grasping something or gripping it, or even by turning your wrist. It occurs when the tendons become swollen.

Finkelstein Test

Your doctor performs a simple test to diagnose de Quervain’s tenosynovitis. It is called the Finkelstein test.

The first step is bending your thumb, so it rests along your palm. Then you make a tight fist by closing your fingers over your thumb.

In the end, you turn your wrist down toward your pinky finger. If you feel pain at the base of your thumb, then the test is positive for de Quervain’s syndrome.

Extra tests such as X-rays usually aren’t required to diagnose the condition.

Nonsurgical Treatment

1. Avoiding activities that cause pain and swelling

The purpose is to ease the pain and inflammation when you move your thumb and stop it from happening again.
Applying ice to the site of your pain is considered a soothing remedy worldwide in case you notice swelling.
It would be best also to practice exercises to re-build strength in your wrist, hand, and arm.
This usually makes symptoms go away on their own without any further treatment.

2. Splints

If you’re treating carpal tunnel syndrome or losing grip, doctors advise the use of Splints to rest the thumb and wrist.
We would recommend wearing it every day for 4 to 6 weeks.
You may try wearing a splint just at night to stabilize the compressed nerves in your thumb and wrist.

3. Anti-inflammatory medication (NSAIDs)

These are the medications that can be taken orally or injected into the tight covering or sheath surrounding your tendon. This may help reduce swelling and relieve pain.

You’ll start with over-the-counter, oral medications recommend by your doctors to reduce the swelling, such as

  • ibuprofen
  • naproxen
  • acetaminophen

You might fully recover with no need for more treatment if you do this within 6 months after you notice symptoms.

4. Corticosteroids

Your doctor may also recommend the injection of corticosteroids into the tendon sheath to reduce swelling and pain.
Most people recover completely after receiving corticosteroid injections within the first six months. Results may show even after one injection.

Surgical Treatment

If nonsurgical treatments do not help relieve pain and swelling, your doctor may recommend surgery.
Surgery for de Quervain’s tendinosis is an outpatient treatment which means you can go home just afterward.

It is typically done under local anesthesia or with mild sedation.

During the surgery, your doctor inspects the sheath surrounding the involved tendons. Then they make a tiny cut in the sheath to release the pressure, so your tendons can slide smoothly.

This surgery aims to eliminate pain and swelling and restore the range of motion to the thumb and wrist.

Can de Quervain’s tenosynovitis be prevented?

To prevent de Quervain’s tenosynovitis, you must

  • Avoid repetitive movements
  • Limit the activities that cause pain
  • Take breaks and avoid overusing your wrist.
  • Wear a splint on your thumb and wrist for support
  • Follow your doctor’s advised actions and avoid other movements.

Limiting these activities could prevent future issues regarding de Quervain’s tendinosis.

Recovery

If it did not need surgery, it is a chance for you to get better within 3-5 weeks if you strictly follow the activity plan advised by your doctor. Yet, recovery from surgery could take a while.

Your pain and swelling should go away in 10 to 14 days after getting stitches removed.
Then you’ll start physical therapy for a month or two. Your physician will administer your stretches to help strengthen your thumb and wrist.

Recovery times vary, depending on your

  • Age
  • General health
  • How long the symptoms have been presentIf your condition has developed gradually, the swelling and pain are more challenging to get rid of. It might take a little longer for symptoms to disappear, but you will regain the strength for the range of motion of your thumb and wrist.