Quervain’s tenosynovitis is characterized by affecting the tendons of the wrist, causing pain and a significant limitation in the common movements made with the wrist and thumb. In this publication, the COPAC medical team will explain to you in simple and understandable language what De Quervain’s tenosynovitis is, what its causes are, symptoms, treatments and risk factors.
De Quervain’s disease is a painful disorder that causes inflammation of the extensor tendons that pass through the wrist. When the wrist is overused, internal friction occurs that over time can lead to inflammation of the tendons and the synovial sheath that covers them, causing the symptoms of tenosynovitis to appear.
Women between 30 and 50 years of age are the most likely to suffer from Quervain’s tenosynovitis. Men can also develop this condition, but it is much more common in women.
De Quervain’s tenosynovitis can be caused by any daily activity where the person has the need to perform repetitive movements with their hands or wrists, for example:
Practice racket or paddle sports such as: tennis, table tennis, paddle tennis, golf, hockey, etc.
Carry out gardening, cooking, hairdressing work.
Constantly holding a nursing baby.
Use the PC keyboard for a long time.
Holding heavy bags frequently.
Suffering from rheumatoid arthritis or other inflammatory diseases.
People with Quervain’s tenosynovitis have the following symptoms:
Pain at the base of the thumb that is aggravated by twisting/twisting the wrist or moving the thumb.
Dull pain in the wrist that spreads slightly to the forearm and thumb.
Inflammation.
Redness.
Increased wrist temperature (heat).
Weakness in placing the fingers of the hand in "pincer".
Diagnosis of Quervain’s tenosynovitis usually includes thorough examination of the wrist, hand, and thumb; as well as the performance of specific tests, such as: the Finkelstein maneuver and the Eichhoff maneuver. However, in some cases an ultrasound is needed to make the diagnosis of the condition, the images obtained will help the specialist to clearly identify the magnitude of the inflammation of the tendons and the presence of fluid in the tendon sheath.
In these cases, conservative and surgical treatment have the same intention: to reduce the inflammation, to keep the movement of the thumb normal and to prevent the disorder from recurring. In this sense, the treatment of De Quervain’s tenosynovitis may include the following:
The use of over-the-counter analgesic and anti-inflammatory medications is highly recommended in this type of situation. Corticosteroid injections on the tendon sheath are also common to quickly reduce inflammation; It should be noted that most people experience a marked improvement from the first injection.
The specialist may initially suggest immobilizing the wrist and thumb to allow the tendons to rest from usual activity, or simply stopping movements with both parts (wrist and thumb) as much as possible.
A physical therapist can teach you the correct way to use your hands and wrists so that you don’t put so much strain on them, they can also recommend muscle-strengthening exercises and other techniques to make you feel less pain.
Surgery is usually reserved for the most serious cases, that is, for those where a full recovery has not been achieved after having complied with the conservative scheme. The type of procedure applied in these cases is outpatient, being a surgery in which the specialist makes a small incision on the wrist to access the inflamed tendon sheath and release the contained pressure by making a cut on it.
After surgery, you will likely need the help of a physical therapist to strengthen and rehabilitate the operated wrist; as well as the hand and fingers, in order to achieve complete recovery.
The condition continued without treatment for a long period of time can cause pain that spreads to the thumb and forearm, resulting in limitation of movement of the wrist and thumb. The patient may have difficulty using the affected hand and wrist in the future due to the loss of range of motion that results from a disease such as tenosynovitis.
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