De Quervain's Tenosynovitis: Symptoms, Causes, Treatment, Exercises

Key Takeaways

• De Quervain's Tenosynovitis is an inflammatory condition affecting the tendons on the thumb side of the wrist, causing pain and limited mobility.

• Look for localised pain, swelling, catching sensations, and reduced range of motion in the thumb and wrist.

• Treatment includes rest, anti-inflammatory medications, exercises, and potential natural remedies.

• Focus on ergonomic practices, hand exercises, and avoiding repetitive strain.

• At MSK Doctors, we offer comprehensive care, and a patient-centric approach for treating De Quervain’s Tenosynovitis.

Understanding Quervain's Tenosynovitis

De Quervain's Tenosynovitis is an inflammation of the tendons on the thumb side of your wrist. This condition can make it painful to turn your wrist, grasp objects, or make a fist. The pain is often located at the base of the thumb, where it meets the wrist, and may extend up the forearm.

Main Symptoms

• Localised Pain and Tenderness: The primary symptom is pain or tenderness located at the base of the thumb on the radial side of the wrist. This pain can develop gradually or suddenly and often worsens with activities involving thumb and wrist movement, such as making a fist, grasping objects, or twisting the wrist.

• Swelling and Inflammation: Swelling is a common symptom, often visible as a noticeable bump or thickening at the base of the thumb. This swelling can extend into the thumb and, in severe cases, up the forearm. Inflammation leads to increased sensitivity and discomfort in the affected area

• Catching or Snapping Sensation: Many individuals experience a "catching" or "snapping" feeling when moving the thumb, which can be accompanied by a squeaking sound (crepitus) as the tendons move through the swollen sheaths.

• Numbness: Some people may feel numbness along the back of the thumb and index finger due to nerve irritation or compression.

• Thumb Stiffness and Limited Range of Motion: Stiffness in the thumb is common, leading to a reduced range of motion. 

Common Causes

Activities that require frequent hand and wrist movement, such as gardening, playing sports, or lifting infants, can lead to this condition.

Certain risk factors can increase the likelihood of developing De Quervain's. 

• Age

• Gender (it is more common in women), 

• Inflammatory conditions like rheumatoid arthritis. 

• Hormonal changes during pregnancy can also contribute to the onset of symptoms.

Diagnosis Techniques

Diagnosing De Quervain's Tenosynovitis typically involves a physical examination. A healthcare provider will ask you to perform specific movements to assess pain and swelling in the affected area. 

One common test is the Finkelstein test:

1. Where you make a fist with your thumb inside your fingers 

2. And bend your wrist toward your little finger. 

3. If this movement causes pain, it might indicate De Quervain's.

Effective Treatment Options

Non-Surgical Interventions

For many individuals, non-surgical treatments are effective in managing symptoms. Rest is the first step, as it helps reduce inflammation. Avoid activities that worsen the pain and consider using a splint to immobilise the thumb and wrist, allowing the tendons to heal.

Anti-inflammatory medications, such as ibuprofen or naproxen, can help alleviate pain and swelling. In some cases, corticosteroid injections may be recommended to provide more immediate relief.

Natural Pain Relief Methods

Herbal Remedies

Herbal remedies have been used for centuries to alleviate pain and inflammation. Turmeric, known for its anti-inflammatory properties, can be consumed as a supplement or added to meals. Ginger is another powerful anti-inflammatory herb that can be consumed as tea or added to food.

You can incorporate these remedies into your diet: 

• Turmeric: Add to smoothies, teas, or meals.

• Ginger: Consume as tea or use in cooking.

• Willow Bark: Often used as a natural pain reliever, similar to aspirin.

However, always consult with a healthcare professional before starting any new supplement, especially if you have existing health conditions or are on medication.

Heat and Cold Therapy

Heat and cold therapy are effective methods for managing pain and inflammation. Cold therapy, such as applying an ice pack, can help reduce swelling and numb sharp pain. Apply ice for 15-20 minutes every few hours as needed. 

Heat therapy, like using a warm compress or heating pad, can relax tense muscles and improve blood circulation. Apply heat for 15-20 minutes to the affected area, especially before performing exercises. 

Diet and Nutrition

A diet rich in anti-inflammatory foods can help reduce symptoms of De Quervain's Tenosynovitis. Focus on incorporating omega-3 fatty acids found in fish like salmon, as well as nuts and seeds.

Make sure you consume plenty of fruits and vegetables, especially those high in antioxidants, such as berries, leafy greens, and bell peppers. These foods can help reduce inflammation and support overall joint health. 

Exercise for Relief and Prevention

Exercise plays a crucial role in both relieving pain from De Quervain's Tenosynovitis and preventing future flare-ups. By strengthening the muscles and tendons in your hand and wrist, you can improve function and reduce strain.

Thumb Exercises

Thumb exercises focus on improving flexibility and strength in the thumb and surrounding muscles. 

One effective exercise is the thumb lift. To perform this exercise:

1. Place your hand flat on a table, palm up. 

2. Slowly lift your thumb away from the table

3. Hold for a few seconds, and then lower it back down. 

4. Repeat this movement 10 times.

Another exercise is the thumb flexion stretch. To do this exercise: 

1. Begin by holding your hand out with your palm facing you. 

2. Gently bend your thumb across your palm towards the base of your little finger. 

3. Hold this position for a few seconds before returning to the starting position. 

4. Repeat 10 times.

Wrist Exercises

Wrist exercises aim to enhance flexibility and strength in the wrist area, which can help alleviate tension on the tendons. 

Start with the wrist extension exercise:

1. Hold your arm out in front of you with your palm facing down. 

2. Use your other hand to gently push your fingers back towards your body, feeling a stretch in your wrist. 

3. Hold for 15-30 seconds and repeat three times.

Next, try the wrist flexion exercise:

1. With your arm extended and palm facing up, 

2. Use your opposite hand to gently push your fingers down towards the floor. 

3. Hold the stretch for 15-30 seconds and repeat three times.

General Hand Exercises

Incorporating general hand exercises can also benefit those with De Quervain's Tenosynovitis by promoting overall hand health. 

One simple exercise is the finger spring. Start by: 

1. Placing a rubber band around your fingers and thumb, 

2. And then spread them apart against the resistance of the band. 

3. Repeat this motion 10 times.

Another effective exercise is the grip strengthening. Start by: 

1. Squeeze a soft ball or a rolled-up towel in your hand, 

2. hold for a few seconds, and release. 

3. Perform this exercise 10 times with each hand.

Long-term Management Strategies

• Regularly perform the recommended exercises to keep your wrist and thumb flexible and strong.

• Adopt ergonomic practices in your daily activities to minimise strain on your hands and wrists.

• Incorporate anti-inflammatory foods into your diet to support joint health.

• Stay active and maintain a healthy weight to reduce stress on your joints.

Get Expert Care at MSK Doctors

At MSK Doctors, we understand that De Quervain's Tenosynovitis is more than just a painful wrist condition—it's a barrier to your daily life and activities. 

Our approach transcends traditional treatment by combining cutting-edge technology with personalised care. 

Our team of leading orthopaedic consultants specialises in precise, minimally invasive treatments that address the root cause of your condition. From advanced regenerative techniques to comprehensive rehabilitation strategies, we provide end-to-end care that sets us apart from conventional medical approaches.

Reclaim your hand's strength and mobility with our specialised care. MSK Doctors offer immediate, expert care - call us today to schedule a consultation with us.

Frequently Asked Questions (FAQ)

What is De Quervain's Tenosynovitis? 

De Quervain's Tenosynovitis is a painful condition causing inflammation of the tendons on the thumb side of the wrist, making it difficult to move the thumb and wrist.

What causes De Quervain's Tenosynovitis? 

Common causes include repetitive hand and wrist movements, pregnancy, inflammatory conditions, and activities like gardening or lifting infants.

How long does it take to recover from De Quervain's Tenosynovitis? 

Recovery varies depending on the severity and treatment approach. With proper care, many patients see improvement within a few weeks to months.

Can De Quervain's Tenosynovitis heal without surgery? 

Most cases can be effectively managed with non-surgical treatments like rest, splinting, exercises, and anti-inflammatory medications.

Why choose MSK Doctors for De Quervain's Tenosynovitis treatment? 

At MSK Doctors, we offer innovative, personalised care using AI technology, advanced regenerative treatments, no GP referral required, and a comprehensive approach to musculoskeletal health.