DE QUERVAINS TENOSYNOVITIS

Symptoms of De Quervain Tenosynovitis:

• Pain near the base of the thumb.
• Numbness along the back of your thumb and index finger
• Swelling near the base of the thumb.
• A squeaking sound as the tendons move within the swollen sheaths.
• Difficulty moving the thumb and wrist when doing something that involves grasping or pinching.
• A “sticking” or “stop-and-go” sensation in the thumb when moving it.

Dr. Pournaras may give your the Finkelstein Test.

This will require you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If you have pain on the thumb side of your wrist, you likely have de Quervain Tenosynovitis.

Treatments for De Quervain’s Tenosynovitis

• Applying heat or ice to the affected area.
• Taking a nonsteroidal anti-inflammatory drug these include ibuprofen (Advil, Motrin) or naproxen (Aleve).
• Avoid activities that cause pain and swelling. Especially avoid those that involve repetitive hand and wrist motions.
• Steroid injections to reduce inflammation and relieve the pressure in the tendon sheath. These injections are very effective and are used regularly.
• Wear a splint 24 hours a day for 4 to 6 weeks to rest your thumb and wrist.

If you have mild symptoms, resting your wrist and thumb, wearing a splint at night,  and taking anti-inflammatory painkillers such as ibuprofen may help.

A steroid injection into the base of your thumb can help treat the problem in 8 in 10 of our patients.

Dr. Pournaras often performs a surgical procedure called a release. The goal of this surgery is to “release” the tendon sheath that wraps around the base of your thumb, relieving pressure and friction and restoring movement at the base of your thumb.

This operation usually is performed under a local anaesthetic and takes about 30 minutes. Dr. Pournaras will make a small cut at the base of your thumb. He will then cut open the fibrous roof of the tunnel that is causing the de Quervain’s disease. This allows the tendons to glide freely through the tunnel. Next he will close the incision up.

This an outpatient surgery that you will be able to go home 2-3 hours after. Its important to rememeber: Keep your effected hand raised and bandaged for 2 days.

Gently exercise your fingers, writs and elbow to prevent stiffness. Regular exercise will help you to return to normal activities as soon as possible.