What Is De Quervain's Disease? Treatment Options

De Quervain’s disease, also known as De Quervain’s tenosynovitis, is a condition that affects the tendons on the thumb side of your wrist. It occurs when the tendons around the base of the thumb, specifically the extensor pollicis brevis and abductor pollicis longus tendons, become inflamed and constricted. This inflammation leads to pain and tenderness, especially when forming a fist, grasping, or turning the wrist.

The exact cause of De Quervain’s disease is often unclear, but it is believed to result from repetitive strain on the thumb, leading to irritation of the tendons and their sheaths. Activities that involve repetitive thumb movement, such as typing, gaming, or sports like tennis and golf, can increase the risk of developing this condition. New mothers are also at risk due to the repetitive strain from lifting their baby.

Symptoms of De Quervain’s Disease

• Pain and Tenderness: The most common symptom is pain and tenderness on the thumb side of the wrist. This can extend up the forearm and can be particularly noticeable when making a fist, grasping, or turning the wrist.
• Swelling: Some individuals may notice swelling over the affected area, though this is not always present.
• Limited Mobility: The pain can lead to limited mobility of the thumb and wrist.
• Snap or Click: When moving the wrist, some people may experience a snap or click, which is due to the tendon moving through the inflamed sheath.

Treatment Options for De Quervain’s Disease

Treatment for De Quervain’s disease is aimed at reducing pain and inflammation and allowing the tendon to heal. The treatment approach can vary depending on the severity of the condition and the individual’s response to different therapies.

1. Conservative Management

• Rest and Avoidance: Avoiding activities that aggravate the condition is crucial. This might involve changing the way you perform certain tasks to reduce strain on your thumb and wrist.
• Ice: Applying ice to the affected area can help reduce pain and inflammation.
• Compression: Wearing a wrist splint can help reduce strain on the wrist and thumb.
• Elevation: Elevating your wrist above the level of your heart can help reduce swelling.

2. Physical Therapy

• A physical therapist can provide exercises and stretches to help improve range of motion and reduce pain. They might also recommend techniques to modify daily activities to reduce strain on the affected tendons.

3. Medication

• Pain Relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation.
• Corticosteroid Injections: Injecting corticosteroids into the affected tendon sheath can reduce inflammation and relieve pain. However, repeated injections can weaken the tendon and are generally limited to two or three injections.

4. Surgery

• In severe cases or when conservative treatments fail, surgery might be necessary. The goal of surgery is to open the tendon sheath to relieve pressure on the tendons, allowing them to move more freely.

Prevention of De Quervain’s Disease

While not all cases can be prevented, reducing repetitive strain on the thumb and wrist can lower the risk. This includes: - Taking regular breaks during activities that involve repetitive thumb movements. - Practicing exercises that strengthen the muscles of the thumb and wrist. - Ensuring proper ergonomics during work and play, especially for those who engage in activities that involve prolonged typing, gaming, or use of vibrating tools.

Conclusion

De Quervain’s disease is a treatable condition, and most people can find relief from their symptoms through conservative management and, in some cases, medical intervention. Understanding the causes, recognizing the symptoms, and seeking early treatment are key to preventing long-term damage and restoring full function and comfort to the wrist and thumb.