De Quervain's syndrome

De Quervain's syndrome or De Quervain's tendinosis is a condition that causes pain, swelling and tenderness on the thumb side of the wrist due to inflammation of the tendons in your wrist and lower thumb.

Two of the tendons which help to straighten the thumb pass through a single tunnel on the thumb’s side of the wrist. When these tendons swell, they tend to become constricted by the narrow tunnel through which they pass, causing friction. This causes a "catching" or "snapping" sensation and pain with certain thumb and wrist movements such as forming a fist, grasping or gripping something.

What are the causes of De Quervain's tendinosis?

The cause of De Quervain's tendinosis or syndrome is unknown but seems to be related to a direct blow to the thumb, hobbies like computer gaming or gardening, overuse and inflammatory conditions such as arthritis.

How is De Quervain's syndrome treated?

While De Quervain's syndrome is not harmful, it can cause chronic pain. Treatment is thus aimed at reducing pain and relieving the inflammation of the tendons.

In very mild cases medication can be used to control the pain. In certain cases it may be useful to rest the wrist using a splint, but in most cases conservative management will include a cortisone injection into and around the tunnel.

In severe cases where conservative treatment options have failed, surgery may be advised by your hand surgeon. The goal for surgical decompression of the tendon tunnel is to release the pressure on the tendon so that it can move smoothly. Using local or general anaesthesia, your hand surgeon will widen the tendon tunnel by splitting its roof. Over time this will heal but will be slightly wider, giving the tendons enough room to move without friction. The duration of symptoms and severity of disease will determine how quickly you recover. Your hand surgeon can advise you on the best treatment for your case.