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deQuervain’s Tendonitis



deQuervain's tendonitis, named after a Swiss surgeon, is inflammation of the wrist tendons near the base of your thumb.  This can cause swelling around the tendon within the tendon sheath, causing pain when you move your thumb or wrist.  Common activities that elicit symptoms are holding objects, making a fist, or lifting infants; the latter is so common that some people refer to this as a “new parent disease.”  Repetitive activities and awkward hand positioning contribute to the inflammation.

Pain in the thumb-side of your wrist which increases with hand and thumb motion is the main symptom.  Irritation of your nerve overlying the tendon sheath might cause numbness on the back of the thumb and index finger.  A fluid-filled cyst can be present in the area of swelling as well. 
The “Finkelstein test,” performed by making a fist around your thumb and moving your hand away from the painful side of the wrist, causes pain in a patient with de Quervain’s tendonitis.

Conservative management using oral anti-inflammatories along with splinting and activity modification to rest the inflamed tendons  works.  Remember that these non-operative treatments can help only if you use them, so just having the splint in your nightstand won’t help you!  In very painful cases, a corticosteroid injection into the tendon sheath sometimes can alleviate symptoms.

In rare cases, when sy
mptoms persist despite non-operative treatment, surgery to open the tendon compartment can be performed.  Your hand surgeon will help you determine the best treatment for your situation.