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St. Mary's Center for Orthopaedics

De Quervain Syndrome

What is De Quervain Syndrome (Tenosynovitis, Tendonitis)?

De Quervain’s Syndrome, (also known as DeQuervain Tenosynovitis or DeQuervain Tendonitis), is a condition caused by an inflammation of the tendons located at the thumb side of the wrist. Tendons are tissues that attach our muscles to our bones.  They can become swollen and sore from over use.  If you have de Quervain’s tendonitis it will probably hurt every time you turn your wrist, grasp anything or make a fist.  Although the exact cause of de Quervain’s tendonitis isn’t known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports or lifting your baby can make it worse.

What are the Symptoms of De Quervain Syndrome?

The first symptom of de Quervain’s tendonitis is usually pain and swelling in the wrist on the thumb side. It may also be difficult to grab and pinch things. The pain may increase and hurt along the tendons up to the thumb. In severe cases, a small, firm nodule may develop at the base of the thumb and a noise may be heard from the tendons rubbing against each other.

Symptoms of de Quervain Syndrome include:

  • Pain near the base of your thumb
  • Swelling near the base of your thumb
  • Difficulty moving your thumb and wrist when you’re doing activities that involve grasping or pinching
  • A “sticking” or “stop-and-go” sensation in your thumb when trying to move it

If the condition goes too long without treatment, the pain may spread farther into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

What Causes De Quervain Syndrome?

DeQuervain’s tendonitis is usually caused by overuse of the wrist. Repetitive wringing, grasping, clenching or pinching can cause irritation and inflammation that presses on the tendons, restricting their ability to move.  Less common causes include rheumatoid arthritis and scar tissue from a previous injury.  While this condition can affect anyone, it is most often seen in people ages 30-50 and is more common among women. It is also very common in new moms or those who frequently hold small children due to the way we posture the wrist when holding a child.

What are the Treatment Options for De Quervain Syndrome?

Treatment options may include the following and will depend on severity of the condition:

Non-surgical Treatment Options

  • Wrist brace
  • Anti-inflammatory medication
  • Restricted movement of wrist
  • Ice
  • Cortisone injections
  • Physical or occupational therapy

Non-surgical treatments can be effective if treated early and activities that caused de Quervain’s tendonitis are stopped. If such activities resume, as may be necessary for work, the tendonitis can worsen. If non-surgical treatments are not effective in relieving pain and restoring function of the hand and wrist, surgery may be required.

Surgical Treatment Options

Through a small incision, a small slit is made in the tendon sheath that encases the tendons. This releases pressure on the tendons so they stop rubbing against each other and inflammation can subside. This is considered a minimally invasive outpatient procedure and is typically performed with a local anesthetic.