Tendinitis or tenosynovitis of Quervain is a condition that is produced by irritation of the wrist tendons on the thumb side . The irritation causes an inflammation in the lining around the tendons , which can hinder the movement of them.
Those who suffer from it usually feel pain and sensitivity when turning the wrist , close your fist or grab various items. Although men and women may suffer, the latter are the most affected, especially when they perform work or activities that involve repetitive movement in the area.
What are the causes of Quervain's tendinitis?
Tendons are fibrous structures that connect muscles to bones. Although it is not known exactly what produces Quervain's tendonitis , is handled by hypothesis that is caused by an irritation of the sheath that covers the two tendons of the wrist and the lower part of the thumb. This, in turn, is related to factors such as:
- Repetitive movements that include the thumb; how to write on the keyboard or use the mouse.
- Microtrauma on the area of the thumb or the outer part of the wrist.
- Degeneration tendinous by age.
- Pathologies as the rheumatoid arthritis .
- sports that involve repetitive movements of the hand and wrist; like tennis or golf.
See also: Exercises to strengthen the wrists
Symptoms of Quervain's tendonitis
The main symptom of Quervain's tendonitis is a pain on the thumb side of the wrist. This can manifest gradually, although it can also appear abruptly. The pain can radiate to the forearm and tends to get worse when activities are performed where the hand and thumb should be strained. Symptoms also include:
- Numbness of the fingers thumb and index
- Swelling of the wrist.
- Rigidity by moving your thumb or wrist.
- Hypersensitivity in the area of the wrist and thumb.
- Difficulty of movement or functional limitation.
How is Quervain tendonitis diagnosed?
To diagnose Quervain's tendonitis, the doctor will examine the hand to determine if there is pain by applying pressure to the wrist on the side of the thumb.
After this a test known as Finkelstein maneuver . In this, the patient must close his hand by making a fist with his fingers on his thumb. Then, flex the doll towards the little finger to check the intensity of the pain. If this action produces a strong pain, the diagnosis suggests Quervain's tendonitis.
On the other hand, although it is not necessary, a soft tissue ultrasound can be done to confirm the diagnosis.
We recommend you read: 6 remedies to relieve pain in the wrists
Treatment of Quervain tendonitis
For a satisfactory treatment, the doctor takes into account the severity of the symptoms. In the beginning, a conservative (non-surgical) treatment is used focused on the relief of inflammation and pain. If this does not work, surgery may be suggested.
In order to decrease pain and swelling, the doctor suggests the use of painkillers over-the-counter such as ibuprofen and naproxen.
As well the injection of corticosteroids into the tendon sheath is recommended to decrease inflammation. If this treatment starts during the first six months of the symptoms, there is a high probability of having a complete recovery in a short time.
For decrease the severity of symptoms and accelerate the recovery process , the therapy includes:
- Immobilization of the thumb and wrist with a splint or device to support the tendons.
- Avoid repetitive movements with the thumb.
- Apply ice to the affected area.
As well It is advisable to visit the physiotherapist or occupational therapist. These professionals can assess which movements affect the wrist and how to make adjustments to decrease the strain they cause on the tendon. Additionally, exercises for the wrists and hands can be practiced in order to strengthen the muscles and reduce rigidity.
The most serious cases do not respond to the previous treatments. That is why, As a last route for treatment, outpatient surgery is recommended. This procedure seeks to increase the space of the tunnel to release tension and facilitate the sliding of the tendon.
Once this intervention is completed, the doctor explains in detail what guidelines should be taken into account for the rehabilitation process . As usual, To avoid future problems, periodic visits with the physiotherapist are assigned.
- Martinez Peric, Rodrigo. «Disease of DÂ'QuervainÂ»
- Gabriel Celester Barreiro: De Quervain's tendinopathy . Review of concepts. Iberam. Cir. Hand, vol. 37, no. 2, November 2009.
- De Quervain's Tenosynovitis: Finkelstein's Test .
- Arroyo J., Delgado P.J., Fuentes A., Abad J. M., (2007), Surgical Treatment of Stenosing Tenosynovitis of Quervain, editorial Fundación MAPFRE, vol. 5 N ° 2, pp. 1-6.