DeQuervains tenosynovitis is a painful condition that affects two of the tendons that help straighten and bring the thumb back away from the palm. The extensor pollicis brevis and abductor pollicis longus tendons run through a tight tunnel as they make their way up the forearm towards the thumb. Irritation of the tendons can cause pain and inflammation in this area, which is worsened by moving the hand and wrist.
The exact cause is unknown. DeQuervains can be caused by prolonged use of your hand and wrist, in activities, occupations or sports that involve repeated gripping, grasping and twisting of the wrist and thumb, as well as when undertaking unusual activities such as a gardening project or DIY. Direct injuries can cause inflammation here, such as a knock to the wrist, as well as inflammatory conditions such as rheumatoid arthritis.
DeQuervains can be experienced by new mothers, possibly due to hormonal changes in the body or due to a sudden change in their usual activity (for example, on repeated lifting of their baby or repeated breast or bottle feeding).
Many symptoms will settle with a period of rest and avoiding activities that cause pain.
Medication (such as simple painkillers or anti-inflammatories) may be useful. A pharmacist or healthcare practitioner can help advise you what to take if needed. You can find further information here on what medications you could take here:
How and when to take paracetamol for adults – NHS (www.nhs.uk)
Ibuprofen for adults: painkiller which also treats inflammation – NHS (www.nhs.uk)
You may find heat helpful to ease stiff and painful joints. Try filling a bowl with warm water or resting your hand on a microwaved heat pack for 10 minutes. Do not use heat if your joint is hot and swollen as it may make it worse. Instead you can consider using an ice pack or bag of frozen peas.
Place a tea towel on your wrist (to protect your skin from ice burns), and then place an ice pack or bag of frozen peas over the painful area. Leave this on for ten minutes and use up to 3 times per day.
Immobilising the wrist and the thumb with a splint (purchased online, or via a sports shop) for a short period (1-2 weeks) may help to settle the pain and inflammation. You could try this for two weeks, day and night. Take it off regularly to maintain the movement in your thumb wrist and fingers.
Here is an example of a suitable splint you could try.
Try and identify what caused your De Quervain’s and take steps to prevent it from happening again. Changing the way that you use your hands and taking regular breaks will help to reduce the strain on your tendons.
Avoid repetitive activities, especially those that involve the thumb, and activities where you hold an object still for a period of time with your wrist bent and the thumb wide open. For new Mothers, this may mean that you have to adapt to new ways of lifting and positioning your baby. Try using a pillow to help support your baby, avoid lifting or lift in a different way.
General movement of the hand and wrist can be beneficial to maintain range of movement and prevent stiffness.
Speak to your healthcare practitioner if your symptoms persist, despite trying the self-management techniques listed above.
Steroid injection can relieve the pain in approximately 70% of cases. This can often be undertaken by GPs, or you can be referred to a physiotherapy practitioner or hand surgeon.
The tendon tunnel can be released surgically in some cases under a local or regional anaesthetic. More information about these options can be found here, as well as a discussion regarding the risks involved:
De Quervain’s syndrome | The British Society for Surgery of the Hand (bssh.ac.uk)
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