De Quervain’s tenosynovitis is a painful condition of the thumb and wrist due to inflammation of two tendons. It seems to be more common in women than men, and there are multiple causes. Pregnant women and new mothers are a high risk group probably because of the generalised increased swelling, but also due to poor posture. This is especially noticeable when carrying the newborn, or positioning for feeding.
Wrist and thumb flexion together with ulnar deviation (moving the wrist towards the little finger) is particularly painful as it places these tendons on maximum stretch against the tight covering of the extensor compartment. Some common activities include turning on taps or door handles, lifting teapots or mugs, lifting babies in and out of car seats, or baths. Students coming up to exams may also notice these symptoms due to extended periods of writing with forced pinch grip.
©️Mayo Clinic
Treatment begins with activity modification and avoidance of bad positioning. Sometimes wearing a firm splint to protect the area may be helpful. Topical anti-inflammatory medication can help with pain relief. A good Hand Therapist can fashion a splint that allows function yet protects the affected area, and they can also guide you through tendon gliding exercises which can also help in the early stages.
If these measures fail to help, De Quervain’s tendinitis can respond to ultrasound guided steroid injections around both tendon sheaths. If performed accurately it can help reduce the inflammation and this may be enough to settle it down completely. Failing all of these, surgery may be required to relieve pain and prevent further tendon injury or rupture.
As always, it is best to see your local Doctor for an assessment and diagnosis before starting any treatment.