Have you experienced severe pain while flexing your thumb and wrist? This pain could be what’s called De Quervain’s Tenosynovitis. It sounds exotic but is a condition caused by a constriction or pinching of the wrist tendons at the base of the thumb. The constriction occurs around the first dorsal compartment. The condition is named after the Swiss surgeon who first identified it in 1895 – Fritz De Quervain. It is also known in our modern era as:
- Texting thumb
- Gamer’s thumb
- Blackberry thumb
- Washerwoman’s sprain
- Mother’s wrist
- Mommy thumb
- Radial styloid tenosynovitis
- De Quervain’s disease/De Quervain’s syndrome
How did I get this?
The first question that may come to mind is: how did I get it? De Quervain’s Tenosynovitis is a repetitive strain injury, where posture of the thumb is held in abduction and extension. Workers who perform rapid repetitive activities involving pinching, grasping, pulling or pushing have been considered at increased risk. These movements are associated with many types of repetitive housework such as:
- chopping vegetables
- stirring/scrubbing pots
- vacuuming, cleaning surfaces
- drying dishes
- pegging out washing
- mending clothes
- harvesting and weeding
De Quervain’s Tenosynovitis can also come from trauma like a blow to the first dorsal compartment.
Other risk factors
The following factors increase the risk of a person developing De Quervain’s Tenosynovitis.
- Age – people between 30-50 years old
- Gender – it is more common in females due to things like childcare. Which is why it is sometimes referred to as “mother’s wrist” or “mommy thumb”. Lifting a baby over and over throughout the day requires using the thumb and wrist motion at the same time.
- Pregnancy – similar to carpal tunnel syndrome, pregnant women are more prone to this condition
What does it feel like?
The thumb is the only finger to exhibit de Quervain’s Syndrome pain. Usually the tendons on the outside area of your thumb and wrist hurt the most. Other possible symptoms:
- Dull or sharp pain when grasping, making a fist or turning your wrist
- Extending your thumb
- Swelling may occur at the base of the thumb or side of the wrist
- The area may be sensitive when pressure is applied
- In less severe cases, patients may feel their thumb “sticking” when trying to move it. Some describe the thumb “catching on something” when trying to extend
- If condition worsens, pain may spread into the entire thumb and towards the forearm
- Pain is easily increased by make grasping or pinching motions with thumb going into palm
De Quervain’s Tenosynovitis is simple for doctors to diagnose and usually does not require imaging. Your doctor will do the Finkelstein test by bending the wrist toward the pinky, then bending the thumb across the palm. If it elicits pain during this combination of motions, then test is positive. Other tests are done to rule out CMC joint osteoarthritis of the thumb, carpal tunnel syndrome, intersection syndrome and Wartenberg’s syndrome. All of which have symptoms of pain in the thumb.
If you have DeQuervain’s Tenosynovitis there are two forms of treatment. Nonsurgical treatment is geared towards reducing the swelling. Your doctor may prescribe anti-inflammatory medication, wearing a thumb spica orthotic, refer you to hand therapy or a cortisone shot. If nonsurgical treatment options are not effective, surgical treatment would be the next option. Your doctor will provide more information on how they do the procedure, recovery time and precautions.