What is Dequervain’s tenosynovitis?
Inflammation of two tendons as they travel through a small tunnel on the thumb side of the wrist. These tendons allow the thumb to move. The tendons normally slide easily through the tunnel, but sometimes they become swollen, causing movement to be painful. It can occur after repeated hand motions like pinching, gripping, wringing, and lifting. It is more common in women, and associated with wrist trauma, new parents lifting their baby, pregnancy, diabetes, rheumatoid arthritis, and jobs with repetitive hand and wrist motions.
What are the symptoms?
- Pain with gripping, lifting, pinching, or making a fist
- Sometimes, pain and numbness into the wrist and forearm
- Pain and numbness over the base of the thumb
- Pain and swelling over the thumb side of the wrist
- “Catching” feeling when trying to move the thumb
- Grip weakness
What medical tests will I need?
- X-Rays: to rule out any abnormal bone structures that might be causing your symptoms.
- Finkelstein test: you will make a fist, and your wrist will be bent towards your small finger. This stretches the inflamed tendons, and causes pain in those with tenosynovitis.
How is it treated?
- Braces: this keeps the thumb straight and allows the swollen tissues to rest.
- Anti-inflammatory Medicine: controls swelling in the wrist. These include naproxen, ibuprofen, and meloxicam.
- Steroid injections: anti-inflammatories injected into the side of the wrist. This can be repeated every 3 months.
- Surgery: the goal is to prevent symptoms from returning, and most patients report resolution of symptoms.
What do I need to know about surgery?
- You will be contacted within 2 weeks of your pre-op visit for pricing and scheduling.
- The surgery will last less than 30 minutes and you will go home the same day.
- You will be in a splint for 2 weeks that will keep your wrist from moving. After the splint is removed, there are no restrictions on movement.
- You will not be able to lift with that hand until 4 weeks after surgery.
- Your surgeon will make small incision over the thumb side of the wrist and cut the ligament that pinches the tendons.
- The bandage over the incision should be kept clean and dry.
- At your 2 week follow up visit, the sutures and splint will be removed, and you will begin scar massage.
- If you are having symptoms in the other hand, you will be given the option to have surgery at your 4 week follow up.