DE QUERVAIN'S TENOSYNOVITIS
TENDONITIS

De Quervain’s Tenosynovitis / Tendonitis

deQuervains tendonitis is a painful condition of the thumb, commonly seen in women of younger age.

The tendons pass to the thumb via a tight sheath (tunnel) as it crosses the wrist joint. The sheath is formed of tough ligament and lined by tenosynovium that allows the tendons to glide without friction. deQuervain’s tenosynovitis is due to inflammation of the lining of the tendon sheath and results in thickening of a small segment of the sheath. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement.

The main symptoms are pain and tenderness on the side of the wrist which are aggravated by use of thumb. Patients may have a catching or snapping sensation. There may be some swelling at the wrist and grating sensation when the thumb is moved. Sideward deviation of the wrist and bending of the thumb typically causes discomfort.

Although there is no specific cause why this happens, its more commonly seen

women in the age group of 20 –
Overuse has been suggested as a cause, but the relationship of work related disease remains controversial.
Often seen in the third trimester of pregnancy due to water retention.

Conservative treatment comprising rest, activity modification, non steroidal anti-infammatory medications may be helpful in early stages and when symptoms are mild.
Splint: may help in reducing symptoms and usually use as an adjunct to other treatment modalities.
Steroid injection is effective in around 2/3^rd of patients. The steroid is injected around the tendon sheath with or without ultrasound guidance.

If pain persists despite non-surgical management, the problem can be resolved by surgical release of the sheath. This is done under local anaesthesia as a day case procedure.