I Was Just Diagnosed with De Quervain’s Tenosynovitis - What Caused It?

Is the base of your thumb swollen and painful? The pain may continue into your wrist. You may see a nodule on the side of your wrist near your thumb. It’s hard to pick up a coffee cup or hold a toothbrush. You know it’s time to see a specialist.

Board-certified orthopedic surgeon Dr. Jonathan Shults with Coastal Empire Orthopedics treats several musculoskeletal hand conditions, including de Quervain’s syndrome. It’s a form of tenosynovitis, an inflammation of specific tendons and surrounding tissue. 

What is de Quervain’s tenosynovitis? 

When you have de Quervain’s tenosynovitis, the sheath that covers the tendons in your thumb is irritated and becomes swollen. As you move your thumb, the swollen tendons create friction against the sheath that covers them. The area becomes increasingly irritated, causing pain in the thumb, which can extend into your arm. It can become difficult to move your thumb. 

What causes de Quervain’s tenosynovitis? 

Certain factors increase your risk of developing de Quervain’s syndrome. 

Overuse injury 

You may have de Quervain’s tenosynovitis from chronic overuse of your hand and thumb. It could result from a hobby or the type of work you do. Anyone who uses frequent hand motions has a higher risk of this ailment. 

For example, some industrial and construction workers repeatedly use fine motor skills and hand movements. Artists and hairdressers hold paintbrushes and grip scissors for hours at a time. Childcare workers are prone to de Quervain’s from picking up infants and toddlers repeatedly. 

Certain hobbies can increase your risk for de Quervain’s. Golf and tennis require you to grip your equipment firmly and intermittently for prolonged periods. Constantly texting with your thumb on your phone could also cause an overuse injury. 

Pregnancy

Some women experience de Quervain’s syndrome when pregnant. Hormonal shifts can result in fluid accumulation in your hands and wrists. This causes the tendons in your thumb to rub against the sheath covering them, creating friction and irritation. 

Being a woman 

Women are 8-10 times more likely to get de Quervain’s syndrome than men. Hormonal changes, pregnancy, and tasks like lifting your baby and toddler all contribute to women’s higher risk of this form of tenosynovitis. 

Having a chronic illness 

Having a chronic illness increases your risk of de Quervain’s syndrome. Rheumatoid arthritis, diabetes, and other illnesses create systemic inflammation in your body, targeting the tendons in the wrist and thumb as well as those in other locations. 

Past thumb or wrist injury 

If you previously injured your thumb or wrist, you could develop scar tissue which interferes with tendon movement. 

Treatment of de Quervain’s tenosynovitis 

In order to heal, you’ll need to rest the wrist and thumb. We prescribe a splint or brace to ensure your hand rests during the day and while sleeping. We provide a doctor’s note if your condition affects your work. You can apply ice at home several times a day. 

Over-the-counter anti-inflammatory medication can help calm the initial inflammation. If you’re in severe pain, we may administer a steroid injection at the site of your inflammation. 

We prescribe specific exercises or physical therapy to help you regain the range of motion in your hand that you have lost. If your condition doesn’t improve with conservative treatment, Dr. Shults can perform minor surgery to release the sheath covering your tendons. 

Call Coastal Empire Orthopedics or book an appointment online with unexplained hand pain.