De Quervain’s Tendinosis is a stenosing condition of the tendon sheaths on the thumb-side of the wrist. It is usually caused by repetitive and/or forceful wrist and thumb actions such as in golfing, rowing, and racket sports. Furthermore, it has been associated with hormonal changes in women during pregnancy, when breastfeeding, and through menopause.
The tendons (which attach muscle to bone) of extensor pollicis brevis (EPB) and abductor pollicis longus (APL) run from the forearm down to the wrist and attach to the base and IP joint of the thumb.
These tendons are wrapped in slippery (synovial) sheaths which help to provide frictionless movement of the thumb and wrist. They do this by allowing the tendons to slide easily through the compartment that holds the tendons in place.
- De Quervain’s is an overuse syndrome. It occurs when the tendon sheaths of two tendons in the wrist become irritated. The sheaths and tendons swell, causing pain and difficulty of movement.
- De Quervain’s can be caused by repetitive wrist action, hormonal changes, and direct trauma.
What do I feel?
- Pain on the thumb-side of the wrist. This pain may spread up the forearm or into the thumb.
- Swelling near the base of the thumb.
- Painful thumb and/or wrist movements.
- Squeaking/clicking of the painful area during movement.
What can I do?
- Rest – refrain from doing the repetitive actions which cause the pain.
- Protect the thumb by wearing a splint.
- Do not avoid movement completely or the wrist may stiffen up – take the splint off every so often and do some gentle, pain free wrist and thumb movements.
- Take anti-inflammatory medications regularly as prescribed by your health professional.
- Engage in an active rehabilitation programme with a hand therapist.
The rehabilitation of de Quervain’s tendinosis can take six to twelve weeks. Once the initial pain starts to decrease, a rehabilitation programme can commence. This usually includes movement, strengthening and stretching exercises. It is important to commit to your rehabilitation programme to prevent chronic injury that may require surgery.