Emergency and Urgent Care - De Quervain's Tenosynovitis

What is De Quervain's Tenosynovitis?

De Quervain’s Tenosynovitis is a condition affecting the tendons that run into the thumb. These tendons run through a tunnel or sheaths which are involved in the movement of the thumb. It is the inflammation of this tendon sheath that leads to increased pain, thus can become a nuisance and very painful.

What causes Tenosynovitis?

In most cases the exact cause is unknown; it is however more common in women after pregnancy.

The pain and inflammation has been found to become worse particularly from overuse and repetitive movement and use of the tendons (the area shown in the diagram). It can also be brought on by a simple strain, work or sports.

What are the symptoms?

• Pain and swelling to the thumb side of the wrist
• Pain becomes increasingly worse when straightening thumb, lifting thumb or using scissors

What is the treatment and management?

De Quervain’s Tenosynovitis is not harmful, but we recognise it is painful, frustrating and a lengthy healing process. Mild cases have and do recover over a period of a few weeks.

• Avoid performing task or activities that cause further stress or pain, when possible
• Specialist wrist braces with thumb isolators can be advised
• Rest is important it helps to reduce pain and limits movement of the affected tendons
• Pain killers: Take simple pain killers such as paracetamol and /or ibuprofen if you are able to take them, these can be purchased from a chemist or shop. Always take medication according to the manufacturer’s instructions
• Apply Ice or something cool every 2 hours for 20 minutes for the next 24 to 48 hours, ensure the Ice or frozen peas is wrapped in cloth or a towel, DO NOT APPLY DIRECTLY TO SKIN this could cause a burn

Further management after the above initial treatment may include:

• Physiotherapy
• Referral to a specialist
• Steroid Injection
• Surgery

Follow up

There will be no routine follow up for patients with De Quervain’s tenosynovitis. If after 2 to 3 weeks you are still experiencing any of the following please contact your GP for further management, treatment or advice:

• Significant pain
• Swelling
• Reduced range of movement

If you have any concerns please contact the Emergency department for further advice on 0161 627 8926.

The Royal Oldham Hospital, Rochdale Road, Oldham, OL1 2JH.