De Quervain tenosynovitis

Overview

De Quervain tenosynovitis (dih-kwer-VAIN ten-oh-sine-oh-VIE-tis) is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain tenosynovitis, you will probably feel pain when you turn your wrist, grasp anything or make a fist.

Although the exact cause of de Quervain tenosynovitis isn't known, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports, or lifting a baby — can make it worse.

Symptoms

Symptoms of de Quervain tenosynovitis include:

• Pain near the base of the thumb
• Swelling near the base of the thumb
• 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

If the condition goes too long without treatment, the pain may spread farther into the thumb or forearm or both. Moving the thumb and wrist may make the pain worse.

When to see a doctor

Consult your health care provider if you're still having problems with pain or function and you've already tried:

• Not using your affected thumb
• Applying cold to the affected area
• Using nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)

Causes

De Quervain tenosynovitis affects the two tendons on the thumb side of the wrist. Tendons are ropelike structures that attach muscle to bone.

Chronic overuse, such as repeating a particular hand motion day after day, may irritate the covering around the tendons. If the covering becomes irritated, the tendons can thicken and swell. This thickening and swelling restrict the movement of the tendons through the small tunnel that connects them to the base of the thumb.

Other causes of de Quervain tenosynovitis include:

• Inflammatory arthritis, such as rheumatoid arthritis.
• Direct injury to the wrist or tendon, which may cause scar tissue that restricts movement of the tendons
• Fluid retention, such as from changes in hormones during pregnancy

Risk factors

Risk factors for de Quervain tenosynovitis include:

• Age. People between the ages of 30 and 50 have a higher risk of developing de Quervain tenosynovitis than do people in other age groups, including children.
• Sex. The condition is more common in women.
• Being pregnant. The condition may be associated with pregnancy.
• Baby care. Lifting a child repeatedly involves using the thumbs as leverage and may be associated with the condition.
• Jobs or hobbies that involve repetitive hand and wrist motions. These may contribute to de Quervain tenosynovitis.

Complications

When de Quervain tenosynovitis goes untreated, it can become difficult to use the hand and wrist properly. The wrist may lose some range of motion.