De Quervain's Tenosynovitis
AT BEL AIR CENTER FOR PLASTIC AND HAND
De Quervain’s syndrome is the inflammation of the sheath surrounding the two tendons that control thumb movement. This causes pain when moving the thumb, as well as tenderness at rest. There can also be swelling over the side of the wrist where the thumb rests. Problems with gripping and muscle weakness are also associated with de Quervain’s syndrome.
Understanding de Quervain’s Syndrome
Tendons are strong fibrous tissues that connect the muscles to the bones. In de Quervain’s syndrome, the tendons that control the thumb become inflamed. This happens when the tunnel that surrounds them becomes narrower due to tissue changes. When the lining of the tunnel thickens, the space within grows smaller, putting pressure on the tendons. Then, when the tendons move in response to thumb or hand movement, inflammation develops.
De Quervain’s syndrome, sometimes also called gamer’s thumb or mother’s wrist, causes pain through the base of the thumb and along the side of the wrist where the thumb is. In some cases, there may be visible redness and swelling around the base of the thumb. Besides feeling discomfort with motion, other symptoms of de Quervain’s syndrome include problems with grasping small objects, especially while twisting the wrist.
The exact cause of de Quervain’s syndrome isn’t known. However, repetitive use of the wrist and thumb, especially in a twisting motion, can make symptoms worse. Recent injury to the area can also cause symptoms, and scar tissue from an old injury can restrict tendon movement, further increasing tendon pain. Inflammatory conditions like arthritis can also cause increased inflammation.
Surgical Treatment for de Quervain’s Tenosynovitis
Treatment for de Quervain’s syndrome begins with a noninvasive approach. Keeping the wrist and thumb immobile to allow the inflammation to heal is the first step. Taking over-the-counter anti-inflammatory medication like ibuprofen can also help keep symptoms under control. Steroid injections can be helpful when other treatments aren’t helping enough.
However, if the pain is persistent even after trying more conservative treatment methods, surgery may be recommended. During surgery, the restricted covering surrounding the tendons is released. This relieves pressure on the tendons to allow freedom of motion again. Without the constant friction, inflammation and pain through the tendons is able to heal.
Recovery and Results
Recovery following surgical cubital tunnel treatment occurs gradually. Initially, patients need to wear a bandage to help the wrist heal properly. Hand therapy is often included as part of the healing process to increase range of motion. Although it can take a long time for nerves to heal, many patients experience significant relief of symptoms after recovery. Bel Air Center for Hand Surgery helps men and women from Harford County and surrounding areas in Maryland and Pennsylvania improve their quality of life by minimizing painful symptoms and restoring function.