DEQUERVAIN'S TENDONITIS

This condition, brought on by irritation or inflammation of the wrist tendons at the base of the thumb, causes the sheath around the tendon to swell, making thumb and wrist movement painful when grasping or holding objects.

Cause

DeQuervain's tendonitis is usually caused by taking up a new, repetitive activity. New mothers are especially prone to this type of tendonitis, because caring for an infant often creates awkward hand positioning. Hormonal fluctuations associated with pregnancy and nursing exacerbate the situation. A wrist fracture can also predispose a person to deQuervain's tendonitis, as a result of increased stresses across the tendons.

Prevention

Keeping the body strong and flexible is a key to prevention. Avoid prolonged repetitive stressful movements, and take frequent breaks at work if this type of activity is required.

Treatment

The goal is to relieve the pain through non-operative treatment, including resting the thumb and wrist, by wearing a splint. Oral anti-inflammatory medication may be helpful. A cortisone-type of steroid may be injected into the tendon sheath. These are all intended to reduce the swelling, which typically relieves pain over time. In some cases, simply stopping the aggravating activities may allow the symptoms to go away on their own.

When symptoms are severe or do not improve, surgery may be recommended. The surgery opens the sheath to make more room for the inflamed tendons, which breaks the vicious cycle where the tight space causes more inflammation. Normal use of the hand can usually be resumed once comfort and strength have returned.