de Quervain Tendinosis

Causes, symptoms and treatment options for thumb tendonitis

Patients with de Quervain syndrome (pronounced “dek-ER-vane” syndrome) have painful tendons on the thumb side of the wrist. Tendons are the ropes that the muscle uses to pull the bone. You can see them on the back of your hand when you straighten your fingers. In de Quervain syndrome, the tunnel (the first extensor compartment; see Figure 1 A-B in the slides below) where the tendons run narrows due to the thickening of the soft tissues that make up the tunnel. Hand and thumb motion cause pain, especially with forceful grasping or twisting.

What does de Quervain syndrome look like?

Figure 1A: The first dorsal compartment. There are six compartments on the dorsal, or back, side of the wrist. The first and third compartments house tendons that control the thumb.
Figure 1B: A drawing of the first dorsal compartment.
Figure 2A and B: Pain with this motion (a hammering motion with the thumb in the fist) is characteristic of de Quervain syndrome.

Causes of de Quervain syndrome

Doctors are not sure what causes de Quervain syndrome. Patients often describe a feeling of inflammation, but studies have shown that the process is not inflammatory. People of all ages get it. When new mothers develop de Quervain syndrome, it typically appears 4 to 6 weeks after delivery. The old theory that it was caused by wringing out cloth diapers has been replaced by concerns about holding the baby, but changes in hormones and swelling seem more probable.

How is de Quervain syndrome treated?

Treatments that can relieve symptoms include:

  • A splint that stops you from moving your thumb and wrist.
  • Tylenol or aspirin type medications (e.g., ibuprofen).

Treatments that attempt to change the course of the disease include:

  • A cortisone-type of steroid injection into the tendon compartment. It has not been clearly established that these injections change the course of the disease and response to the injection varies.
  • Surgery to open the tunnel and make more room for the tendons.

Learn more about surgery to relieve de Quervain syndrome in this short video

Bothered by thumb, hand, or wrist pain? We can help.

At Carolina Hand & Sports Medicine, our board certified orthopaedic surgeons are highly experienced in advanced treatment for acute injuries and chronic pain in the hand, thumb and wrist.

Make an appointment at our Asheville or Valdese clinic.

© 2016 Carolina Hand and Sports Medicine
Download PDF 

© 2012 American Society for Surgery of the Hand. Developed by the ASSH Public Education Committee
http://www.assh.org/handcare/hand-arm-conditions/de-quervain-syndrome