De Quervain tenosynovitis
Definition
De Quervain tenosynovitis, also called gamer’s thumb or mother’s thumb, is a painful disorder that affects the tendons on the thumb side of the wrist. Tendons attach muscles to bones. A membrane-like structure called a tendon sheath surrounds the tendon, allowing the tendon to move freely inside of it. In De Quervain tenosynovitis, the sheaths that surround the tendons become inflamed when the two tendons at the base of your thumb swell (Figure 1). When you make a fist, turn your wrist, or hold anything, you’ll likely experience pain.
Risk Factors
De Quervain tenosynovitis’ actual cause is unknown; however it has been linked to repetitive wrist motion, specifically occurring at the joint of the thumb. Activities that call for a side-to-side movement of the wrist while you are gripping something with your thumb could worsen this condition, such as:
- Typing
- Long use of computer mouse
- Knitting
- Using a hammer
- Holding a baby for a long time
- Carrying heavy grocery bags
Individuals affected most commonly with this condition:
- Women aged 30 to 50 years
- Mothers of newborns or child care providers
- Those who have had medial or lateral epicondylitis
- Those who have had recent direct blow to the thumb
- People with arthritis
Symptoms
If you have De Quervain tenosynovitis you might experience:
- Wrist pain on the thumb’s side that is frequently made worse by motions of the thumb and wrist
- Swelling near the base of thumb
- Suffering or trouble performing simple actions, such as removing a jar lid
- Catching sensation of the thumb while moving.
1. Physiotherapy
It recommends exercises to increase strength and range of motion as well as minimize pain and inflammation. In addition to offering advice on how to change postures and activities, physical therapists often educate patients about their condition. Physical therapy management can include:
- Massage
- Strengthening exercises
- Grip proprioception training
- Stretching
- Mobilization
- Taping
2. Splinting
A splint that immobilizes the wrist and thumb may be useful for you. Use the splint only during painful activities; do not leave it on for extended periods of time as this might weaken and stiffen the hand. However, it is occasionally required to wear the splint daily for up to 6 weeks. If so, remove it several times daily for hand hygiene and to gently stretch the wrist and thumb to avoid stiffness.
3. Pharmacologic treatments
You could be prescribed an oral anti-inflammatory drug, such as ibuprofen or naproxen, to aid with swelling reduction.
One or two injections of corticosteroids have been reported to produce almost full relief.
4. Activity modification
It is essential to modify any factors that could be causing you pain. These include things like altering your everyday routines and the intensity and frequency of physical activities you engage in:
- Instead of using a pinch, use the power grip (all fingers in a loose grip)
- When doing repetitive motions, reduce repetition as much as possible, take breaks, and/or slow down the motion.
- Hold tools, pens, and the mouse with a gentle touch.
- Switch hands when performing tasks.
5. Surgery
If the symptoms don’t improve after two corticosteroid injections, surgery treatment is a possibility. Around the swollen tendons, the surgeon makes a small incision in the sheath. This gives the tendons greater space to move.
