De Quervain Tenosynovitis: Wrist Pain That Can Be Cured with Proper Treatment

De Quervain tenosynovitis develops from two main causes: repetitive wrist use and minor injury from accidents, such as improper hand positioning.
Tendon and tendon sheath inflammation (De Quervain tenosynovitis) are the most common causes of wrist pain in patients experiencing pain on the thumb side of the wrist.
Wrist pain may also result from other similar conditions, such as basal thumb arthritis and inflammation of other tendons in the wrist.
Wrist tendon inflammation and De Quervain tenosynovitis treatment begins with hand rest and steroid injections to reduce inflammation.
When wrist surgery is needed, it involves a minor procedure to release the tendon sheath where friction occurs, allowing better tendon movement. Patients don’t need to stay overnight in the hospital as the incision is smaller than 1 centimeter.
De Quervain tenosynovitis treatment at kdms Hospital provides specialized care from expert hand and wrist surgeons for targeted and effective treatment, contributing to patients’ new normal life to live.

‘Sharp wrist pain every time I lift something at the wrong angle.’

‘Whenever I try to pick up my baby, my wrist hurts so much I can't lift him/her.’

‘Pain and swelling in my wrist - even picking up a pen to write is difficult’

If you experience wrist pain during small daily activities, this might be a symptom of ‘De Quervain tenosynovitis,’ which is the most common cause of wrist pain. De Quervain tenosynovitis occurs from two main causes: repetitive wrist use and minor injury from accidents, often called “wrong positioning.”

Although De Quervain tenosynovitis is commonly encountered, it shouldn’t be overlooked. While simple tendon inflammation may not be concerning, pain in this area can result from many other causes that require different diagnoses and treatment approaches.

Consulting a doctor for a thorough examination is essential because even though the wrist is small, it contains more complex details than we realize. Initially, we’ll discuss the most common causes of wrist pain: tendon and tendon sheath inflammation (De Quervain tenosynovitis).

Table of Contents

Understanding Wrist Tendons

Wrist is the most frequently used joint in our body, capable of moving in multiple directions. For a wrist to have such flexibility, it relies on surrounding tendons to anchor and pull for movement in various directions. This makes these tendons prone to inflammation and injury.

Besides tendons, there’s another important component: the tendon sheath. It holds the tendons close to the wrist. Although both tissues work together, they become swollen and inflamed when we overuse our wrists, resulting in wrist pain. Which tendons become inflamed depends on our usage patterns. The most common is inflammation of tendons on the thumb side of the wrist ridge, called De Quervain tenosynovitis.

Tendon and Tendon Sheath Inflammation (De Quervain Tenosynovitis)

This is the most common tendon and tendon sheath inflammatory condition in patients with wrist pain.

If you examine yourself, you’ll find this tissue at the bony prominence on the thumb side of your wrist ridge, which houses the tendons that help extend and move the thumb. In patients with De Quervain tenosynovitis, moving the thumb in certain directions will cause immediate sharp pain. There may also be swelling in this area. If symptoms persist for a while, the tendon sheath will thicken and you can feel a raised bump when touching.

Although tendon and tendon sheath inflammation around the wrist are the most common causes of pain in this area, there are other conditions that can cause similar symptoms. Therefore, if resting your affected wrist doesn’t improve the pain, you should see a doctor for diagnosis to prevent the condition from becoming chronic.

Other Injuries and Conditions Similar to De Quervain Tenosynovitis

Since the wrist is small but filled with many important structures, pain in this area may result from multiple causes from nearby organs with similar risk factors. This means some patients may still have symptoms even after treatment with injections or surgery. Therefore, it’s necessary to see a medical specialist for detailed diagnoses.

Similar wrist pain conditions to De Quervain tenosynovitis include:

Basal thumb arthritis and inflammation

It is commonly found, especially in people who heavily use their hands for work.

Activities that cause degeneration and inflammation include work requiring strong thumb pressure, such as using scissors or hand-washing clothes.
Pain occurs at the base of the thumb due to repetitive pinching and grasping activities that accumulate and cause basal thumb arthritis and inflammation.
This condition causes pain close to where De Quervain tenosynovitis occurs.
Basal thumb arthritis may be mistaken for De Quervain tenosynovitis.
This requires experience and expertise from hand specialists to differentiate between conditions.

Other wrist tendon inflammations

Inflammation or injury of other nearby tendons.
May occur alongside De Quervain tenosynovitis.
Requires detailed diagnosis by hand specialists.

Treatment for basal thumb arthritis and tendon inflammation can use methods similar to De Quervain tenosynovitis treatment. In cases with severe symptoms affecting multiple areas, diagnosis must determine which area should undergo wrist surgery for targeted problem-solving. Each patient may have different details of treatment.

Differential diagnosis requires experience and expertise from hand specialists because the areas potentially causing pain are very close together, requiring careful examination and possibly additional appropriate tests for accurate diagnosis.

Progression from De Quervain Tenosynovitis to Other Injuries

De Quervain tenosynovitis cannot develop to other diseases but may connect with injuries or inflammation in other hand locations. Since the cause of inflammation comes from repetitive hand and wrist activities in daily life, there’s a chance multiple tendons may become inflamed simultaneously.

Additionally, wrist tendons often become inflamed alongside finger tendons, causing trigger finger. Also, wrist tendon inflammation and swelling may compress nerves, causing both pain and hand numbness (carpal tunnel syndrome).

De Quervain Tenosynovitis Treatment

Essentially, De Quervain tenosynovitis treatment is divided into stages based on disease severity, starting with avoiding or resting hand use, along with taking anti-inflammatory medication. Physical therapy may be used concurrently. If symptoms don’t improve, steroid injections will be considered to reduce inflammation. Finally, for cases that don’t respond to the above treatments but pain still interferes with daily life, treatment with minor surgery is available.

Initial treatment

Wrist rest is the first and most important recommendation.
Soak the wrist in warm water 1-2 times daily for 15-30 minutes each time, followed by physical therapy.
Perform physical therapy to relieve symptoms, aiming to reduce pain, decrease inflammation, and improve tendon movement.
Take anti-inflammatory medicines to relieve pain and reduce tendon inflammation as well as swelling.

Steroid injections to reduce inflammation

Steroids are popular medications used for injections to reduce inflammation because they work promptly and effectively reduce inflammation at the target area. They don’t have side effects or dangers to worry about because they work locally. Local steroid injections work to reduce inflammation only in the injected area, not affecting other parts of the body.

Generally, steroid injections are limited to no more than 2 times, with appropriate intervals between each injection. If symptoms persist after more than 2 injections, it indicates the disease severity exceeds what medication can treat. Therefore, continued injections are unnecessary because they won’t provide permanent healing.

How Do You Know When Wrist Surgery Is Needed?

When treatment following the above steps still results in pain that ‘interferes with daily life,’ it’s time for surgery. Some people who still have mild pain that doesn’t obstruct daily activities may not need surgery. This decision needs to be made following a consultation between doctor and patient on a case-by-case basis.

Surgery involves releasing the tendon sheath where friction occurs, allowing better tendon movement. Hospital stay after wrist surgery isn’t necessary because it’s minor surgery with an incision smaller than 1 centimeter, taking only about 10 minutes to operate. After surgery, the patient can use their hand normally and pain will improve significantly.

Prevention of De Quervain Tenosynovitis

The most important thing is avoiding wrist use that contributes to injury, such as heavy use and repetitive use. Therefore, preventing tendon and tendon sheath inflammation means using hands and wrists appropriately, not excessively.

For homemakers who do housework and use wrists regularly, adjust wrist usage methods to reduce its burden. For example, change from hand-washing and wringing clothes by hand to using a washing machine.
Mothers who regularly carry children should modify their lifting posture by squatting down to lift by using the forearm to support the bottom and back. This posture can reduce pressure on the wrist.
For work requiring regular wrist use, use appropriate postures to prevent injury.

Wrist tendons, including tendon sheaths, are important parts of the wrist that help with movement and grasping objects. Although they are not major body organs, they can significantly impact daily life when pain occurs. Therefore, seeing a doctor for early treatment is advisable to maintain “quality of life” for a long time.

What Are the Perks of Having De Quervain Tenosynovitis Treatment at kdms Hospital?

For De Quervain tenosynovitis treatment at kdms Hospital in Bangkok, Thailand, patients will meet with experienced hand and wrist surgeons who will create individualized treatment plans for each patient, whether behavioral modification in daily activities, medication use, physical therapy, or surgery. Therefore, patients can return to living a normal life as well as before.

Q & A

De Quervain tenosynovitis treatment is divided into stages based on disease severity, starting with avoiding or resting hand use, along with taking anti-inflammatory medication. Physical therapy may be used concurrently. If symptoms don’t improve, steroid injections will be considered to reduce inflammation.

The most important thing is avoiding wrist use that contributes to injury, such as heavy use and repetitive use. Therefore, preventing tendon and tendon sheath inflammation means using hands and wrists appropriately, not excessively.

For homemakers who do housework and use wrists regularly, adjust wrist usage methods to reduce its burden. For example, change from hand-washing and wringing clothes by hand to using a washing machine.
Mothers who regularly carry children should modify their lifting posture by squatting down to lift by using the forearm to support the bottom and back. This posture can reduce pressure on the wrist.
For work requiring regular wrist use, use appropriate postures to prevent injury.