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| HAND & WRIST PROBLEMS |
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| DeQuervain's Tendinitis |
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| What is it? |
| DeQuervain’s tendinitis is a condition brought on by
irritation or swelling of the tendons found along the
thumb side of the wrist (Figure 1). The irritation causes
the compartment (lining) around the tendon to swell,
changing the shape of the compartment; this makes
it difficult for the tendons to move as they should. The
swelling can cause pain and tenderness along the
thumb side of the wrist, usually noticed when forming
a fist, grasping or gripping things, or turning the wrist. |
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| What causes it? |
| The cause of DeQuervain’s tendinitis is an irritation of
the tendons at the base of the thumb. For example,
awkward hand positions required by a new mother
in caring for an infant is a common cause of this
condition. |
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| Signs and symptoms. |
| Pain over the thumb side of the wrist is the main
symptom. The pain may appear either gradually or
suddenly. It is felt in the wrist and can travel up the
forearm. The pain is usually worse with use of the
hand and thumb, especially when forcefully
grasping things or twisting the wrist. Swelling over the
thumb side of the wrist is noticed and may be
accompanied by a fluid-filled cyst in this region.
There may be an occasional “catching” or
“snapping” when moving the thumb. Because of the
pain and swelling, it may be difficult to move the
thumb and wrist, such as in pinching. Irritation of the
nerve lying on top of the tendon sheath may cause
numbness on the back of the thumb and index
finger. |
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| Diagnosis. |
| A Finkelstein test is generally performed. In this test,
the patient makes a fist with the fingers over the
thumb. The wrist is then bent in the direction of the
little finger (Figure 2). This test can be quite painful for
the person with DeQuervain’s tendinitis. Tenderness
directly over the tendons on the thumb-side of the
wrist is the most common finding, however. |
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| Treatment. |
| The goal is to relieve the pain caused by the irritation
and swelling. In some cases, your doctor may
recommend resting the thumb and wrist by wearing
a splint. Anti-inflammatory medication taken by
mouth or injected into that tendon compartment
may help reduce the swelling and relieve the pain.
In some cases, simply not doing the activities that
cause pain and swelling may allow the symptoms to
go away on their own. |
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| When symptoms are severe or do not improve,
surgery may be recommended. The surgery opens
the compartment (covering) to make more room for
the irritated tendons (Figure 3). Normal use of the
hand can usually be resumed once comfort and
strength have returned. Your hand surgeon can
advise you on the best treatment for your situation. |
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| Copyright © American Society for Surgery of the
Hand 2001. |
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