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De Quervain's Tenosynovitis

DeQuervain’s tenosynovitis consists of inflammation and irritation of the tendons along the side of the wrist and the thumb. This can become a painful condition and limit the ability to use the thumb, as well as grip and manipulate objects.

The main tendons associated with DeQuervain’s tenosynovitis are the abductor pollicis longus and extensor pollicis brevis. These tendons allow the thumb to bend, extend and grip objects. Overuse, repetitive movements that involve excessive thumb or side to side motion of the wrist and arthritis are the most common predisposing factors for experiencing this type of injury. This can occur with physical demands like hammering, painting, golfing or even a simple motion such as cutting with scissors.
Symptoms usually gradually worsen and are described as a dull ache on the thumb side of the wrist. Pain is typically worse with deviating the wrist towards the pinky and bending and pinching the thumb. A common test that a medical provider might perform in order to rule in the diagnosis of DeQuervain’s tenosynovitis is the Finkelstein test. This test consists of tucking the thumb inside of the hand making a fist. Then deviate the wrist towards the pinky side of the hand.

Conservative treatment of this condition consists of modifying irritating activities in an effort to allow the structures in the hand to calm down. Like most tendon conditions, a gradual strengthening program can not only assist in decreasing pain, but prevent a reoccurrence of injury. If pain persists, splinting the thumb may be required to decrease irritation of the tendons. Rarely is surgery needed, but if surgical intervention is required, it typically consists of doing a release of the compartment and tendons of the thumb.

Landan Morgan, DPT

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