Tendinosis (or tendonitis) means inflammation of a tendon; De Quervain's tendinosis is the irritation or inflammation of the tendons that run along the base of the thumb. Symptoms include pain and tenderness in the thumb and side of the wrist that can travel up the arm, particularly when gripping or twisting the wrist. Overuse can cause De Quervain's tendinosis, as can pregnancy and its related hormonal changes, and rheumatoid arthritis. This condition is most common in middle-aged women.
Diagnosing De Quervain's Tendinosis
Finkelstein test
To diagnose De Quervain's tendinosis, a physician may ask the patient to place his or her thumb against their hand, making a fist with their fingers closed over the thumb, and then bending the wrist toward the little finger. If the patient has De Quervain's tendinosis, this test is quite painful, causing tendon pain on the thumb side of the wrist.
Treatments for De Quervain's Tendinosis
Bracing/Splinting
A splint, also known as a brace, is a rigid device that holds a body part in place so that it is unable to move. It is usually used as a treatment for a suspected fracture, sprain/ligament damage, or other injury. It can be applied by first responders in the event of trauma. Splints can reduce pain, aid in proper healing, and can also prevent further injury. They can be worn for several days or weeks to hold the body part in place for the duration of healing time.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A class of medications, including but not limited to aspirin, naproxen, and ibuprofen, that are used for reducing pain and redness, swelling, and heat (inflammation) in arthritis and other painful inflammatory disorders.
Activity Modification
Physicians may prescribe general lifestyle changes to a patient, in order to help relieve the symptoms of their condition and improve their overall physical function and well-being. Depending on the medical condition being treated, activity modification may include: decreasing or increasing one's level of physical activity; added rest; beginning a new activity or exercise program; changing sleep habits; or modifying one's physical environment at home, in their vehicle, or at work.
Corticosteroid injections
Also known as cortisone shots, these are injections that may help relieve pain and inflammation in a specific area of the body. Cortisone shots are most commonly given into joints — such as the ankle, elbow, hip, knee, shoulder, spine, and wrist.
Surgery for De Quervain's Tendinosis
This procedure is an option for patients with severe cases of De Quervain's Tendinosis, or whose symptoms do not improve. The goal of the surgery is to open the thumb compartment (covering) to make more room for the irritated tendons. Normal use of the hand usually can be resumed once comfort and strength have returned.