According to The Royal Australian College of General Practitioners, 1.3% of women and 0.5% of men will be diagnosed with this condition (particularly between the ages of 40 and 60).[1] Despite being a non-fatal condition, the Australian Institute of Health and Welfare also noted 1,521 cases presented to Australian hospital in 2019-2020s.[2]
De Quervain’s tenosynovitis was named after a Swiss surgeon named Fritz de Quervain in 1895.[3] Since then, other names have been used for this condition, such as ‘washerwoman’s thumb’, ‘new mother’s thumb’ and ‘gamer’s thumb’. These are named after specific populations who have a higher risk of developing it.
Read on to understand what you should know about de Quervain’s tenosynovitis; the risk factors, treatment options and expected recovery time.
What is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis is an inflammatory condition where the protective tissue (sheath) surrounding the tendons between the wrist and thumb become inflamed. People diagnosed with this condition will often report a sharp and specific pain located between the inner part of the wrist and thumb.
What are the symptoms of de Quervain’s tenosynovitis?
Symptoms of de Quervain's tenosynovitis include pain and swelling at the base of the thumb and difficulty moving the thumb, especially with gripping or lifting tasks. People may also experience numbness or tingling down the outside of the thumb.
Common symptoms of de Quervain’s tenosynovitis
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Swelling near the base of the thumb
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Pain during thumb movements
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Numbness at the back of the thumb
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Snapping sensation during thumb movements
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Difficulty grasping or pinching an object
What causes de Quervain’s tenosynovitis?
De Quervain's tenosynovitis is most commonly caused by repetitive and chronic overuse of the wrist, such as lifting heavy groceries or lifting children into a baby seat. This overuse leads to irritation and inflammation of the tendons in the wrist, causing pain and weakness.
Common causes of de Quervain’s tenosynovitis
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Direct injury to the wrist and tendons of the thumb
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Inflammatory arthritis
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Repetitively lifting of a child
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Hormonal changes during pregnancy
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Previous wrist injury
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Problematic smartphone use
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Too much time on a computer
Sports that increase the risk of de Quervain’s tenosynovitis
Repetitive gripping with bending of the wrist can increase the risk of having de Quervain’s Tenosynovitis.
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Tennis
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Badminton
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Golf
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Volleyball
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Basketball
How is de Quervain’s tenosynovitis diagnosed?
De Quervain’s tenosynovitis is a painful condition that can limit your gripping abilities and prevent you from doing your daily tasks.
A comprehensive check-up of your wrist and thumb is the best course of action to relieve your condition. One of the most recommended solutions by Australian GPs is an assessment with a physiotherapist.
Like most conditions, a physiotherapist will take a detailed history of your activities and previous injuries. This process is commonly referred to as consultation. Take this time to discuss all relevant information about your injury to provide a comprehensive background of your condition.
After taking your history, your physiotherapist will perform a detailed assessment of your wrist and thumb to check for other factors that might be contributing to your injury and rule out other conditions.
Your initial visit with your physiotherapist will typically last for about 30 to 60 mins.From here, your physiotherapist will give you the details of your treatment program. This will include:
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Treatment programs and goals
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Recovery time and treatment expectations
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Home exercises to maximise your recovery
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Recommendations about work and lifestyle modifications
How is de Quervain’s tenosynovitis treated?
De Quervain’s tenosynovitis can be frustrating and limit your ability to participate in sports or perform normal handgrip activities. Inability to efficiently use your thumb can result in complications if left untreated.
There are several options when it comes to treating de Quervain’s tenosynovitis. One of the more common and the treatment option referred to by Australian GPs the most frequently is physiotherapy.
Physiotherapists often see patients with de Quervain’s tenosynovitis for rehabilitation and they are in the best position to treat these kinds of conditions. After the initial assessment, they will give an appropriate treatment plan specific to your lifestyle and situation.
The treatment protocols given to you will involve manual therapy and specific movement exercises to alleviate your pain and help you recover.
De Quervain’s tenosynovitis treatment will focus on decreasing the signs of inflammation, increasing your mobility, and strengthening key muscles of your hand, wrist, and forearms.
Depending on the severity of your de Quervain’s tenosynovitis, a physiotherapist may provide you with a combination of the following types of treatments:
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Therapeutic Exercises - Given to correct impairments in your muscles and joint mechanics brought about by your injury.
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Manual Therapy - Hands-on techniques performed by your physiotherapist to improve your mobility and promote pain-free movements of your wrist and thumb.
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Stretching Exercises - Stretching of the thumb muscles can help relax and lengthen the structures that cause pain.
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Kinesio Taping - Specialised taping to decrease pain when moving the thumb.
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Soft Tissue Mobilisation - Gentle soft tissue therapy on your forearm, wrist and hand to facilitate blood flow, decrease restrictions and pain.
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Ultrasound Therapy - Ultrasound waves penetrate deeper structures of the wrist and hand, stimulating the healing process and reduction of pain.
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Strengthening Exercises - Exercises that promote strength of the forearm and thumb to prevent secondary complications.
Physiotherapy treatment can last for about 30 to 60 minutes. Most patients can feel the difference in just a single session.
Next step - Creating a treatment plan made for you
Your physiotherapist will create a detailed treatment plan based on your goals and lifestyle to maximise your recovery.
Self-care for de Quervain’s tenosynovitis
If you think you have de Quervain’s tenosynovitis, here are the best things you can do and avoid.
Things to do:
- Rest
De Quervain’s tenosynovitis is an overuse injury due to too much stress on the tendons of the thumb. Allowing your hands to rest from your activities can help your healing process.
- Cold Compress
Cold compress reduces the swelling and pain. Apply a cold compress for at least 15 minutes every 4 hours to reduce inflammation.
- Hot Compress
If you are experiencing pain and difficulty moving your thumb for almost a week, you can use a hot compress to relieve stiffness and allow your tendons to relax.
- Immobilisation
Sometimes limiting the movement of your wrist and thumb can be beneficial to prevent further damage to your tendon sheaths. Wear your prescribed split for added awareness
Things to avoid:
1.Avoid pinching motions
Your thumb is responsible for pinching movements. If your thumb tendons are inflamed, doing activities with your thumb can aggravate the pain and swelling.
- Avoid carrying on the affected arm or hand.
Avoid carrying or lifting with your affected hand. Carrying a water pitcher, for example, puts a high amount of stress on the thumb tendons.
Do I need a specialist or surgery?
Your physician may do an ultrasound-guided steroid injection to help relieve the symptoms of this condition.
In severe cases, de Quervain’s tenosynovitis can persist for a long time without a positive response from conservative treatment.
Surgery can offer a solution by opening the tendon sheaths around the tendons of the thumb to relieve the pressure and allow a smooth gliding motion.
Regardless if surgery is warranted or not, your physician may refer you to physiotherapy to provide you with appropriate treatment and start your recovery.
What is the recovery time / prognosis for de Quervain’s tenosynovitis?
Recovery time is largely dependent on your proactiveness to seek professional treatment and the severity of your hand pain and injury.
Full recovery from de Quervain’s tenosynovitis can be achieved within 6 to 12 weeks. Gradually you may be able to move your thumb with decreasing pain.
Important factors in recovery include:
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Focusing on your rehabilitation program daily
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Resuming your sports activity gradually
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Paying attention to pain, and resting as necessary.
Can de Quervain’s tenosynovitis be prevented?
These tips can double as things to prevent de Quervain's tenosynovitis from occurring as well as helping reduce symptoms if you already have it.
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Limit your smartphone usage – using phones means you rely heavily on thumb movements and can cause repetitive stress to your tendons if you do not allow for sufficient rest.
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Do stretching exercises – stretching can help loosen the tension within your muscles and tendon. Stretch your forearm muscles and fingers regularly to prevent injuries like de Quervain’s tenosynovitis.
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Do grip strengthening exercises - improving your grip strength and strength in your forearm muscles can allow your muscles to carry loads in your hands with more efficiency and reduce the risk of injuries like de Quervain’s tenosynovitis.
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Pace your activity - break activities that would put a lot of pressure and stress on your wrist and thumb into smaller tasks to give your body enough time to recover.
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Drink plenty of water - staying hydrated can help reduce inflammation in the body.
Outlook and the main takeaways
De Quervain’s tenosynovitis can be excruciating and limit you from doing your daily activities. Immobilisation and inactivity for a long time can cause gradual weakening of your hands and increase pain.
With proper rest and guided physical treatment, you will be able to manage the symptoms of your condition and allow your body to recover quickly. Book a visit to a physiotherapist near you and start your path to recovery immediately.
Anatomy of the thumb
Two main muscles control the movement of your thumb into extension and abduction (away from the palm.
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Extensor pollicis brevis
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Abductor pollicis longus
These two muscle tendons are covered by sheaths (synovium) that help the tendons move freely.
However, inflammation around the area of these tendons causes these sheaths to become inflamed, resulting in de Quervain’s tenosynovitis, which is characterised by pain and difficulty in moving the thumb.
