What is De Quervain’s Tendinitis (a.k.a Mommy Thumb)?
De Quervain’s Tendinitis is a condition involving constriction and inflammation of swollen tendons at the wrist near the base of the thumb. A couple of the tendons that move your thumb pass through a narrow tunnel (sheath) at the wrist before going into the thumb.
These tendons help to move your thumb in a motion of opening and closing your grip and De Quervain’s Tendinitis is inflammation between the tendon and its surrounding sheath
When the tendons become irritated and swollen, the tunnel becomes excessively tight and leads to further discomfort. The condition is named after a Swiss surgeon, Dr. Fritz de Quervain, who first identified the problem in 1895.
Symptoms of De Quervain’s Tendinitis
Pain, tenderness, and swelling are common. Twisting the wrist and forcefully using the thumb usually causes aggravation of the pain. Any movement of the tendons can irritate the tendon and sheath, causing more inflammation.
Activities like golf, tennis, and lifting that require repetitive hand or wrist movement can make it worse.
Patients with De Quervain’s Tendinitis may notice:
- Pain near the base of the thumb
- Swelling near the base of the thumb
- Difficulty moving the thumb and wrist especially when grasping or pinching
- Sharp pain in the wrist
- Pain that spreads further into the thumb or forearm
Common Causes of De Quervain’s Tendinitis
The condition likely is the result of a genetic predisposition that presents in perimenopausal, pregnant, and post-partum women, though men can also suffer from it.
This condition is known as Mommy Thumb due to its development from stress on the wrist resulting from frequently lifting a child.
Activities that involve repetitive and forceful twisting of the wrist and thumb may lead to developing the condition as well, making De Quervain’s Tendinitis common in musicians, and racket sport and fly fishing enthusiasts. The symptoms of De Quervain’s Tendinitis may arise in patients from adolescence on.
It’s hard to know that you will develop De Quervain’s Tendinitis until you get it and start experiencing pain.
Diagnosing De Quervain’s Tendinitis
Speaking with you to understand the location of your pain and what aggravates it is important to make the diagnosis. A careful physical exam is essential too. An x-ray will evaluate for other possible sources of pain involving the bones and joints of the wrist.
An examination of the entire forearm may be helpful to make sure that there are no unnecessary loads being applied to the tendons to cause more irritation that contributes to the inflammation.
Treatment Options for De Quervain’s Tendinitis
The condition may respond well to splinting, rest, icing, anti-inflammatory medication, and steroid injection which is what a primary doctor may recommend.
In severe or chronic cases, surgery by a hand specialist may be recommended to relieve the constriction on the tendons and allow the inflammation to resolve. This surgery is minimally invasive and generally allows for a quick recovery.
During surgery the tendons and the tunnel are located and an incision is made to split the top of the tunnel which allows the tunnel to open up. The open tunnel creates more space for the tendons to move and relieves the inflammation. The open eventually heals closed but becomes larger than it was prior to surgery.
After surgery tenderness is common around the site of the incision. Physical therapy, range-of-motion exercises, and strengthening exercises may be recommended to aid in recovery.
De Quervain’s Tendinitis rarely goes away on its own but early recognition and treatment are beneficial.
De Quervain’s Tendinitis is common and can make use of your hand and wrist difficult and uncomfortable. Call Dr. Pruzansky at 212-249-8700 to schedule an appointment and relieve the pain.