What is de Quervain’s Syndrome?

Tendonitis is the term used to describe inflammation of a tendon and its surrounding sheath. Tendons are strong, dense cords of a connective tissue, called collagen, that attach muscle to bone. When muscles are contracted, the tendons pull on the bone, causing movement. The specific tendons affected in de Quervain’s syndrome are the extensor pollicis brevis, and the abductor pollicis longus. These tendons allow movement of the thumb.

As a result of trauma or overuse, some or all of the collagen fibers that make up the tendon can become frayed or broken. Given adequate time, they will heal themselves, but if the muscle is not rested the tendon fiber cells are unable to regenerate and tendonitis can develop.

The exact causes of de Quervain’s syndrome are unknown. However, it is known that certain repetitive motions can cause inflammation of the tendons. Actions such as gripping or pinching, or twisting the wrist, use the tendons mentioned above. Unsurprisingly, it is normally the dominant hand that is affected.

Sometimes a trauma such as a direct blow to the area can cause de Quervain’s syndrome, but usually it develops gradually as a result of repetitive and excessive grasping motions.

Rheumatoid arthritis is also known to provoke the condition. Interestingly, women, especially if they are between the ages of thirty and fifty, are up to ten times more likely to develop de Quervain’s than men.

Self-help treatment includes

Resting. Avoiding the movements that cause pain gives the tendon fibers a chance to heal.

Applying ice to the sore area.

Using a splint or brace on the thumb and wrist to keep them immobile while the tendons heal. This can take up to six weeks of wearing the splint twenty-four hours a day. Thumb spica braces are appropriate, although a longer wrist brace can also be used.

Using NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen.

If these treatments don’t work, your doctor may recommend a steroid injection, which helps reduce swelling and pain. This is often very successful at resolving the problem, and can be repeated if necessary.

Surgery is a final option. Normally done on an outpatient basis, the surgeon opens the tendon sheath to relieve the pressure that has built up as a result of the inflammation. This allows the tendon to once again glide smoothly. It can take up to several months for any tenderness to completely disappear, but it is usually possible to return to normal activity within two to three weeks after surgery.

Rehabilitation exercises are recommended, and techniques taught to reduce actions that place stress on the wrists.

De Quervain’s syndrome is a painful condition, so anyone prone to inflammations of this sort would be wise to avoid the sorts of repetitive motions that can aggravate the tendons, or at least break up sessions into shorter periods. It would also be sensible to perform specific exercises regularly to keep the muscles strong and flexible.