By Do you experience thumb pain after repetitive activities such as knitting, gardening, or lifting your new child?
You may be experiencing a common (and treatable!) tendonitis of the thumb called De Quervain’s Tenosynovitis, which can occur in activities such as:
- Knitting
- Gardening
- Playing a musical instrument
- Lifting a child improperly (lift with your shoulders and fixed wrists, not by flexing your wrists)
- Typing
- Carpentry
- Walking pets on a leash
- Sports
What is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is an inflammation of the synovial tissue surrounding the thumb tendons at the thumb side of the wrist – where the tendons have to pass through a tight pulley. As this tissue becomes inflamed, it becomes more difficult and painful for the tendons to pass smoothly through the pulley. Eventually, all thumb movement becomes painful.
How is De Quervain’s Tenosynovitis diagnosed?
The most sensitive test is Finklestein’s test, which will cause pain at back of the thumb for a patient who makes a fist with the thumb inside the fingers, with the thumb side up, and tips the wrist forward and down, as shown below.
To properly diagnose this condition, it is important to visit your hand surgeon, as other conditions such as arthritis, nerve injury, or even fracture can mimic De Quervain’s Tenosynovitis.
How is De Quervain’s Tenosynovitis Treated?
The first step is to identify the cause. Often activity modifications – such as properly lifting a baby or using the proper position for a wrist during knitting – can help alleviate symptoms. Additional options include full-time bracing of the thumb and wrist, anti-inflammatory medications or a steroid injection –all of which can dramatically decrease the inflammation.
Finally, surgical release of the affected tendons can relieve the symptoms of De Quervain’s Tenosynovitis, but is typically reserved for the most serious cases. The vast majority of cases we see at Orthopedic Specialists of Seattle do not require surgery.
If you would like to schedule an appointment with OSS hand surgeons Scott Ruhlman, MD or Wayne Weil, MD for further discussion, please call (206) 633-8100.
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