De Quervain's tenosynovitis is a condition that affects the tendons on the thumb side of the wrist, causing pain and discomfort. It is caused by inflammation of the tendons that control the movement of the thumb, which can be caused by repetitive motions or injury to the wrist.

The symptoms of De Quervain's tenosynovitis typically include pain and swelling at the base of the thumb, and difficulty moving the thumb or grasping objects. The pain may also radiate up the forearm or into the hand.

Treatment for De Quervain's tenosynovitis may include resting the affected wrist, applying ice or heat to reduce swelling, and using non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. In some cases, a wrist splint or brace may be recommended to support the wrist and allow the tendons to heal. If symptoms persist despite these conservative measures, corticosteroid injections may be used to reduce inflammation and relieve pain.

In cases where conservative measures are not effective, surgery may be recommended to release the inflamed tendons and relieve pressure on the nerve. This is typically a minimally invasive procedure that can be performed on an outpatient basis.

Prevention of De Quervain's tenosynovitis involves avoiding repetitive movements of the wrist and hand, taking frequent breaks during activities that require repetitive motion, and using ergonomic tools and equipment to reduce strain on the wrist and hand. Strengthening exercises and stretches can also help to maintain flexibility and reduce the risk of injury.

Chronic overuse of your wrist is commonly associated with de Quervain's tenosynovitis.

Tendons are rope-like structures that attach muscle to bone. When you grip, grasp, clench, pinch or wring anything in your hand, two tendons in your wrist and lower thumb normally glide smoothly through the small tunnel that connects them to the base of the thumb. Repeating a particular motion day after day may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement.

Other causes of de Quervain's tenosynovitis include:

• Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons
• Inflammatory arthritis, such as rheumatoid arthritis

Treatment for de Quervain's tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence.

If you start treatment early, your symptoms should improve within four to six weeks. If your de Quervain's tenosynovitis starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breast-feeding.

Medications

To reduce pain and swelling, your doctor may recommend using over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve).

Your doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.

Therapy

Initial treatment of de Quervain's tenosynovitis may include:

• Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
• Avoiding repetitive thumb movements as much as possible
• Avoiding pinching with your thumb when moving your wrist from side to side
• Applying ice to the affected area

You may also see a physical or occupational therapist. These therapists may review how you use your wrist and give suggestions on how to make adjustments to relieve stress on your wrists. Your therapist can also teach you exercises for your wrist, hand and arm to strengthen your muscles, reduce pain and limit tendon irritation.

Surgery

If your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure so your tendons can glide freely.

Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.