deQuervain's Tendonitis
Generally prompted by awkward hand positions or posture, de Quervain's tendonitis is a condition that results from irritation or swelling of the compartment or tunnel around the tendons along the thumb side of
the wrist. As the lining around the tendons becomes inflamed, the tunnel through which the tendons pass becomes constricted. This constriction makes it increasingly difficult for the tendons to move as they should - causing
pain and tenderness on the thumb side of the wrist when forming a fist, grasping or gripping.
Swelling is noticeable and may be accompanied by a cyst filled with fluid. Patients may also experience "snapping" when the thumb is moved and have difficulty pinching. If the
nerve lying on top of the tendon sheath becomes irritated, patients may also experience numbness on the back of the thumb and index finger.
Risk Factors
de Quervain's tendonitis is commonly found in those required to use their hands in new and awkward positions for a period of time - such as a piano
student, or a new mother feeding an infant a bottle or pushing a stroller.
Diagnosis and Treatment
In determining diagnosis, the patient is asked to make a fist with the fingers over the thumb. The wrist is then bent towards the little finger, while the
level of discomfort and range of motion is assessed. Patients also report tenderness directly over the tendons on the thumb side of the wrist.
Patients suffering from de Quervain's tendonitis are asked to refrain from the activity that prompted the swelling. Anti-inflammatory medication may also be
used to reduce swelling and relieve pain. When the condition is nonresponsive to conservative treatment, a surgical procedure called de Quervain's Release is
performed to open the compartment, or sheath, and widen the constricted area for the irritated tendons.
Rehabilitation and strengthening exercises are established following surgery. |
