De Quervain’s tenosynovitis is a painful condition from an inflammation of specific tendons of the thumb. Normally tendons would slide easily through a tunnel of tissue called a sheath. Inflammation of the tendons cause swelling and tendons can no longer easily slide through the sheaths. 

Risk Factors

• Overuse of the thumb and wrist

• Pregnancy 

• Baby care and Breastfeeding

• Rheumatoid Arthritis

• Gender – Affects more women than men

• Age – Most common in 40s to 50s

Symptoms

• Pain in the wrist along side of the thumb which may appear gradually or suddenly

• Pain that travels into the thumb or from the wrist to the forearm

• Swelling over the thumb side of the wrist

• Feeling of snappy sensation when moving the thumb

Treatment

Treatment options can start with non-surgical treatments to improve symptoms before considering surgical treatment

Non-surgical treatment

• Removable splints to keep wrist straight and thumb in comfortable position

• Non-steroidal anti-inflammatory drugs (NSAIDs) by oral tablet or topical application

• Steroid Injection

• Avoidance of activities causing pain

• Application of ice and/or cold pack to the thumb and wrist area to reduce swelling

Surgical Treatment

An outpatient procedure done using local anesthesia or mild sedation. The goal is to release the tendon sheath to make more room for the affected tendons by performing a tiny cut. This would eliminate pain and swelling and range of motion restored.

When should you see a doctor?

If you have problem using your hand with pain which disrupts your daily routine despite trying not to use the affected thumb, applying ice or cold pack your thumb and wrist area to reduce swelling, and usage of Non-steroidal anti-inflammatory drugs (NSAIDs) – consult a doctor at Thonburi Bamrungmuang Hospital for thorough examination and plan for minimal invasive treatment.