DeQuervain’s Syndrome is a painful condition involving thickening and irritation of the two thumb tendons, Extensor Pollicis Brevis (EPB) and Abductor Pollicis Longus (APL). These tendons start on the forearm and travel down in a small synovial tunnel along the thumb side of the wrist.
The condition was first identified by a Swiss surgeon named Dr Fritz De Quervain in 1895 and affects the movement of the thumb and wrist.
Causes and symptoms of DeQuervain’s Tenosynovitis
Overuse of the thumb and wrist, repetitive activities or inflammatory processes may cause irritation and thickening of the tendons. The main symptoms are pain and “tightness” over the thumb side of the wrist with every day activities such as lifting or carrying a baby, twisting, wringing, pinching or lifting.
This condition is common in new mums, and is also seen in sports that involve gripping such as rowing, kayaking, dragon boat racing, tennis, and squash.
Swelling may be apparent, and in some cases there can be a crunching feeling (crepitus) as you move the thumb or wrist. Occasionally an irritation of the superficial radial nerve leads to hypersensitivity over the thumb aspect of the wrist. Zone 34 sports physiotherapists and hand therapist will be able to confirm your diagnosis on clinical examination. Imaging is generally not required.
Initial management involves rest from aggravating activities, along with a custom made splint that will be made on your initial consult. The splint may be required for approximately 6 weeks. We will be able to guide you in regards to activity modification and provide manual therapy and exercises to achieve optimal recovery.
For long standing symptoms, or when splinting and modified activity does not completely resolve symptoms, a cortisone injection may be indicated. Should you require further follow up we have a network of hand specialists and sports physicians who will assist in your management.