What is de Quervain’s tendonitis?
De Quervain’s (dih-kwer-VAINS) tendonitis (or de Quervain’s tenosynovitis) is inflammation of the sheath that covers the two tendons that help move the thumb. These tendons are located along the thumb-side of the wrist and when one overuses the wrist, it causes these two tendons to become inflamed. The main symptoms include swelling in the wrist and pain on the thumb side of the wrist and usually occurs during pinching, grasping objects or twisting the wrist. Occasionally, people feel a “catching” sensation when moving the thumb.
How do you know if you have de Quervain’s tendonitis?
To diagnose, a clinician will have you perform the “Finklestein Test” where you place your thumb into the palm of your hand and make a fist around it, then bend your wrist down towards the floor. Sharp shooting pain usually occurs along the thumb side of your wrist and is symptomatic of possible de Quervain’s tendonitis.
Who is affected by de Quervain’s tendonitis?
De Quervain’s tendonitis can affect people of all ages; however, it affects women more than men, specifically middle-aged women. Additionally, pregnant mothers during their last trimester and mothers who nurse have a higher chance of acquiring the condition, for which the cause is unknown.
Causes of de Quervain’s tendonitis
Activities that increase your chances of causing/worsening this condition include typing, gardening, knitting, needlepoint, hammering, racquet sports, skiing, using scissors (e.g. hair stylists), opening jars, and wringing out wet clothes.
What can you do at home?
- Anti-inflammatory medications (such as ibuprofen) and ice to decrease inflammation of the tendon sheath in the wrist
- Avoid activities that may aggravate the wrist
- Repetitive thumb motions (e.g. pinching)
- Repetitive wrist motions (e.g. bending your wrist to the thumb side)
- Exercises:
- Using the fingers of your other hand, grip your affected thumb and slowly bend your thumb across your palm until the tip of your thumb touches the base of your little finger
- Hold for 15 seconds
- Repeat 5 times
- Using the fingers of your other hand, grip your affected thumb and slowly bend your thumb across your palm until the tip of your thumb touches the base of your little finger
Place your hand on a table in the “handshake” position with your thumb up. Slowly bring your thumb down 90 degrees in front of your palm until it makes a “C” shape with your index finger.
- Hold for 5 seconds
- Repeat 10 times
Treatments
Treatment for de Quervain’s tendonitis typically includes immobilization of the thumb by splinting in a thumb spica splint, 24 hours a day for four to six weeks (view below).
Additional treatments include
- Iontophoresis to decrease swelling and pain
- 830 Laser to decrease pain and assist in healing tendons and surrounding tissue
- Soft tissue massage
- Range of motion exercises
- Strengthening – begins once your condition improves and pain has decreased
At Flex Physical Therapy, we have an occupational therapist who specializes in elbow, wrist, and hand conditions. After trying these exercises, if you feel no gains have been made, please call us at 800-930-8803.
