Your hands and wrists are essential tools that allow you to work, play and perform everyday activities. How well the hand and wrist interact depends on the integrity and function of the ligaments, tendons, muscles, joints and bones.
Wrist tendonitis can affect upper extremity function, causing disruptions at home and work and negatively impacting quality of life.
The human hand itself is very complex and delicate in structure.
Wrist (De Quervain’s) tendinosis occurs when the tendons around the base of the thumb are irritated or constricted.
The word “tendinosis” refers to a swelling of the tendons. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist.
This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist.
De Quervain’s tendinosis may be caused by overuse. It also is associated with pregnancy and rheumatoid disease. It is most common in middle-aged women.
Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid-filled cyst in this region.
A “catching” or “snapping” sensation may be felt when moving the thumb.
Pain and swelling may make it difficult to move the thumb and wrist.
Physical Examination & Patient History
During your first visit, your doctor will talk to you about your symptoms and medical history. During the physical examination, your doctor will check all the structures of your injury, and compare them to your non-injured anatomy. Most injuries can be diagnosed with a thorough physical examination.
Imaging Tests Other tests which may help your doctor confirm your diagnosis include:
X-rays. Although they will not show any injury, x-rays can show whether the injury is associated with a broken bone.
Magnetic resonance imaging (MRI) scan. If your injury requires an MRI, this study is utilized to create a better image of soft tissues injuries. However, an MRI may not be required for your particular injury circumstance and will be ordered based on a thorough examination by your Peninsula Bone & Joint Clinic Orthopedic physician.
The goal in treating Wrist (De Quervain’s) tendinosis is to relieve the pain caused by irritation and swelling.
Splints may be used to rest the thumb and wrist.
Anti-inflammatory medication (NSAIDs)
These medications can be taken by mouth or injected into a tendon compartment. This may help reduce swelling and relieve pain. Avoiding activities that cause pain and swelling. This may allow the symptoms to go away on their own.
Injection of corticosteroids into the tendon sheath may help reduce swelling and pain.
Surgery may be recommended if symptoms are severe or do not improve. The goal of surgery is to open the thumb compartment (covering) to make more room for the irritated tendons.
Surgery opens the sheath over the inflamed tendons. Regardless of the treatment, normal use of the hand usually can be resumed once comfort and strength have returned.
Conservative Treatment Options
Non-Operative Hand & Wrist Treatments
Peninsula Bone & Joint Clinic
The Orthopaedic physicians at Peninsula Bone & Joint Clinic provide comprehensive services to all members of the family.