Wrist Tenosynovitis (De Quervain's)
Pain in the wrist or thumb when gripping or lifting something. Also called De Quervain's tenosynovitis.
Two tendons running from the wrist to the thumb rub against their sheath and become inflamed. It builds up from overuse of the wrist and can affect people of any age.
Common causes
01
Poor wrist posture and repetitive finger movement
02
Jobs that demand a strong grip
03
Fracture or dislocation around the wrist
04
Hormonal or metabolic changes such as pregnancy or thyroid imbalance
Signs to watch for
- Stiffness and pain from the wrist to the thumb
- Pain when moving the wrist or bending the thumb
- Difficulty turning a bottle cap or brushing your teeth
How we diagnose
X-ray
The basic first test. Further tests may be added for a definite diagnosis.
MRI
Shows soft tissue that X-ray cannot, such as muscles, ligaments, discs, cartilage, nerves and blood vessels.
How we treat it
Mild cases are treated conservatively. If symptoms are mild and there is no muscle wasting, we use anti-inflammatory medication, splinting and injections.
Non-surgical injection therapy
Prolotherapy injects directly into weakened ligaments or tendons to reinforce the fibrous tissue, or a hyaluronic acid injection, a main component of joint fluid, is placed into weakened cartilage.
Extracorporeal shockwave therapy
Used across orthopedics, physical therapy and sports medicine, shockwave therapy aids recovery without surgery or painkillers and suits many conditions that cause acute or chronic pain.
Arthroscopy
Through a minimal incision under about 5 mm, an arthroscope with a tiny camera and special instruments is inserted into the joint. It shows areas that are hard to see on X-ray, allowing accurate diagnosis and treatment at the same time.
When surgery is consideredSurgery can be considered if there is no improvement after 6 months of non-surgical care, if it recurs, or with rheumatoid arthritis. The thickened fibrous tunnel pressing on the tendons is released to reduce friction.