De Quervain’s tenosynovitis

What is it?

De Quervain’s tenosynovitis refers to the inflammation of the soft tissues surrounding the tendons that move the thumb.

How does it happen?

De Quervain’s tenosynovitis is an overuse injury. The tendons of the thumb originate from above the wrist joint. They reach the thumb by going around a bony bump or prominence on the outside of the wrist and by crossing the wrist joint. Where they pass around the bony bump at the wrist, the tendons and tissues surrounding the tendons can be rubbed against the bone. Repeated rubbing can result in microtrauma. To repair this microtrauma the body commences an inflammatory response to the injured tissue.

How does it feel?

De Quervain’s tenosynovitis results in pain and tenderness over the thumb tendons as they cross the top of the wrist joint. Here the tendons may be swollen. When the thumb and wrist are moved, crepitus or creaking of the tendons may be felt or heard.

What should you do?

De Quervain’s tenosynovitis generally does not get better on its own if left untreated and you continue to use your thumb and wrist. If you have or suspect you have De Quervain’s tenosynovitis, you should consult your nearest sports physiotherapist for treatment. In the meantime you should avoid activities which aggravate or prolong your pain. These may lead to the further rubbing of the tendons and their surrounding tissues against the bone, worsening of your pain and a prolonged recovery.

What shouldn’t you do?

If you have or suspect you have De Quervain’s tenosynovitis, you shouldn’t ignore the problem. This can lead to your injury getting worse which may prolong your recovery.

Could there be any long-term effects?

De Quervain’s tenosynovitis does not produce and long term effects as long as it is properly diagnosed and appropriately treated, if not, it can lead to ongoing pain at the wrist and a prolonged lay off from participation.

Management

The assistance of a sports physiotherapist is important in the treatment of De Quervain’s tenosynovitis. Initially, they can assess your problem and establish its severity. From their assessment, the sports physiotherapist will be able to determine an appropriate treatment plan. This may involve activity modification, the taking of anti-inflammatory medications, soft tissue treatment such as massage, and splinting.

Brukner & Khan (2012) Clinical Sports Medicine.