De Quervain’s Syndrome

What is De Quervain’s Syndrome?

It is basically the irritation of the tendons of the two muscles that control the action of the thumb away from the hand. These tendons, in normal conditions, glide smoothly through the sheath around these tendons. Thickening of this sheath causes restriction of the movement of the thumb as well associated pain.

 

What causes it?

The reason for most cases of De Quervain’s syndrome is unknown. However, some cases are ascribed to chronic overuse of the thumb by repetitive movement. This is due to the damage and thickening of the sheath covering the tendons of the two muscles controlling the movement of the thumb. This in turn affects the movement of these muscles. Direct injury and arthritis are some of the other common causes.

 

Do I have it?

If you feel pain or swelling near the base of your thumb, in addition to difficulty in moving your thumb when trying to pinch or grasp, you are likely to have this disease. The physicians can test if you have this condition by suddenly moving the thumb. Infliction of sharp pain usually means that you have the disease.

 

Am I at risk?

Although anyone can get this disease, people aged between 30 and 50, females, pregnancy and baby care are some of the factors making you more prone to having this disease. Hobbies/jobs that require repetitive movement of wrist and thumb in a specific direction such as computer use and extensive message texting on mobile phones has also been noted to be associated with De Quervains’s syndrome. (1) (2)

 

How can it be treated?

Applying ice and taking NSAIDS (non steroidal anti inflammatory drugs) can provide some relief. Wearing a splint can be advised to restrict the movement of the affected area. Injection of steroids to the affected area decreases the swelling and pain. (3) If these conservative methods do not improve the symptoms of De Quervain’s syndrome, surgery may be advised. In such a case, the thickened sheath covering the tendons of the affected muscles is manipulated so that the tendons can glide smoothly.

 

Can I prevent it from happening to me?

Repetitive movement is associated with this condition. So avoiding movement of the hands and wrist in the same direction for extended periods might be helpful. If you notice that an activity causes swelling, pain or numbness in your wrist and thumb, try to avoid it and consult your physician if the symptoms persist. Exercising the hands and the wrists in all directions may help retain the flexibility of the movement of hand muscles. Other preventive treatments include occupational and physical therapy which can train on strengthening exercises allowing the use of other muscles so that the affected muscles are not in constant use. (4) Active care is an important way to prevent De Quervain’s syndrome. (5)

 

 

Works Cited

1. Risk factors for de Quervain’s disease in a French working population. Scand J Work Environ Health. 2011 Sep;37(5):394-401. doi: 10.5271/sjweh.3160. Epub 2011 Mar 21.

2. Risk factors and clinical features of text message injuries. Work. 2012;41 Suppl 1:1145-8. doi: 10.3233/WOR-2012-0294-1145.

3. Systematic review and meta-analysis on steroid injection therapy for de Quervain’s tenosynovitis in adults. Eur J Orthop Surg Traumatol. 2013 Jan 22. [Epub ahead of print].

4. Adoption of preventive measures after returning to work among workers affected by De Quervain’s tenosynovitis. J Occup Rehabil. 2012 Dec;22(4):579-88. doi: 10.1007/s10926-012-9374-0.

5. Conservative care of De Quervain’s tenosynovitis/ tendinopathy in a warehouse worker and recreational cyclist: a case report. J Can Chiropr Assoc. 2012 Jun;56(2):121-7.

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