What is de quervain's tenosynovitis?

De Quervain's (say "duh-kair-VANZ") tenosynovitis, also called De Quervain's, is a problem that makes the bottom of your thumb and the side of your wrist hurt. When you have de Quervain's, the ropey fiber (tendon) that helps move your thumb away from your fingers becomes swollen.

De Quervain's may cause pain when you twist your wrist. You might also have pain if you grab something between your thumb and fingers. Many people hear a funny sound like a squeak, crackle, snap, or creak when they move the wrist or thumb.

The bottom of the thumb or the side of the wrist might also be sore or swollen. This can make it hard to move your thumb or wrist. The back of the thumb and index finger may also feel numb. Sometimes de Quervain's can cause a small bump on the thumb side of the wrist. If you don't get treatment, the pain can spread up your forearm or down into your thumb.

Your doctor will check for swelling, tenderness, or numbness around the base of the thumb. There may also be crackling or popping when you move your thumb.

Your doctor may or may not use the Finkelstein test to help diagnose de Quervain's. To do this test, make a fist with your thumb inside. Then bend your wrist outward toward your little finger. If you feel pain on the thumb side of your wrist, then you most likely have de Quervain's.

The Finkelstein test is done to make sure that you do not have a different problem, such as arthritis in the bottom of your thumb or intersection syndrome. Both of these problems affect the same area of the hand and wrist as de Quervain's.

The goal of treatment for de Quervain's is to relieve the pain and swelling in your thumb and wrist and to restore normal function.

Symptoms often get better in a few weeks with home care. Your doctor may want you to start some gentle stretching exercises once your symptoms are gone.

But if your wrist or thumb still hurts, your doctor might give you a steroid shot. This is injected into the thumb side of your wrist area. Most people feel better after just one shot, but you might need another shot after 4 to 6 weeks if your wrist and thumb still hurt. No more than 3 shots are used.

If your wrist and thumb do not feel better after trying home treatment and getting 3 shots, your doctor might talk to you about surgery.

• Until your symptoms are better, stop the activities that caused the pain.
• Avoid moving the hand and wrist that hurt.
• Follow your doctor's directions for wearing a splint to keep your thumb and wrist from moving.
• Try ice or heat.
  • Put ice or a cold pack on your thumb and wrist for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • You can use heat for 20 to 30 minutes, 2 or 3 times a day. Try using a heating pad, hot shower, or hot pack.
• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.