Are you unable to do your daily tasks properly because of pain coming from the side of your thumb, right under your wrist? Does this pain become unbearable when you touch something, squeeze it, or maybe even pick up your little baby? Then this story will be very important for you. Today we are talking about a condition that many people suffer from, but do not know exactly what it is, but can be cured with very simple treatments.
What is De Quervain's Tenosynovitis?
Simply put, De Quervain's Tenosynovitis is a painful swelling of the sheath around the tendons that connect your thumb. It is sometimes called De Quervain's tendinosis. Both names refer to the same condition.
Now let's see how to understand this a little more simply. Imagine that the muscles in our body are connected to the bones by something like a strong rope. We call these tendons . When you contract a muscle, this tendon stretches and moves the corresponding bone. There are two tendons like this that connect your thumb to your wrist.
Normally, these tendons travel inside a sheath of tissue that is like a tube. They move around without any problems. But if for some reason this sheath swells or thickens, the tendons don't have enough room to move freely. Then, every time you use your thumb, there is a lot of friction and severe pain . This pain usually starts at the base of the thumb and can spread up the wrist and towards the forearm.
What are the symptoms? How do we recognize this?
There are several key characteristics that help identify this condition. Let's take a look at what they are.
| Symptom | A description about it |
|---|---|
| The main symptom - pain | This pain occurs on the side of the wrist where the thumb is. For some people, it may start suddenly, while for others it may gradually increase. The pain is especially severe when using the hand, wrist, or thumb, or when squeezing something (e.g., squeezing a cloth). |
| Swelling | You can see a small swelling where the pain is, that is, at the base of the thumb. |
| A 'tick' sound or sensation | When you move your thumb, you may feel a pinching sensation or a 'clicking' sound. |
| A hard feeling/a hangover | The thumb may feel stiff, unable to bend or unbend smoothly and easily. |
| Numbness | Sometimes you may feel a tingling sensation in your wrist or thumb. |
Why do we have this? What are the reasons?
Anything that puts pressure or trauma on the tendons in the thumb can cause this condition. The main causes are:
- Overuse of the hand and thumb: This condition can occur when you continuously perform the same type of movement.
- Doing the same type of work all the time: Some jobs or hobbies can cause this. For example, someone who spends a lot of time typing on a computer, someone who does carpentry, someone who plants, or someone who plays sports like tennis are more likely to develop this.
- Joint inflammation: If you have a joint inflammation condition like arthritis, that could also be a cause.
- Direct trauma: A hard blow to your thumb or wrist can also cause this condition.
This condition is especially common among new mothers. It can be caused by the pressure on the thumb when lifting, bathing, or holding a baby. That's why it's sometimes called "new mother's thumb."
Who is most at risk of developing this condition?
Although anyone can develop this, some people are at a slightly higher risk.
- For women
- For those over 40 years old
- For caregivers and parents of young children
- For those who do manual labor (e.g. farming, carpentry, masonry)
- For players
How do you find this, Doctor?
When you go to see a doctor, he will examine your hand and wrist. He will ask you things like when the pain started, what kind of work you do, and what makes the pain worse.
There is a very simple test that doctors use to accurately diagnose this disease. It is called the Finkelstein test . Here is how it is done:
1. The doctor will tell you to bend your thumb inward and close it with your other fingers to make a fist.
2. Then, the hand holding the handle is asked to bend the wrist towards the side where the little finger is (downward).
If you experience severe pain at the base of your thumb when you bend it this way, it's likely De Quervain's disease. Sometimes, an X-ray may be done to check for other conditions, such as osteoarthritis.
What do we do about this? What are the treatments?
To heal this condition, the tendon and its covering need to be given time to heal. The doctor will prescribe treatments that will help with that.
| Treatment method | What happens to it? |
|---|---|
| Wearing a splint | You will be given a special support (splint or brace) to keep your wrist and thumb in place. This gives the tendons a rest. |
| Ice-laying | You can apply ice to reduce swelling and pain. Wrap an ice cube in a thin cloth and place it on the painful area for about 20 minutes several times a day. |
| Rest | This is essential . You should stay away from the activity that caused the pain as much as possible. Giving your hand a break is very important for a speedy recovery. |
| Painkillers | Your doctor may recommend NSAIDs, which reduce swelling and pain. However, do not use these for more than 10 days at a time without consulting your doctor. |
| Corticosteroid injections | If other treatments don't relieve the pain, your doctor may inject a strong medicine called a corticosteroid into the inflamed tendon sheath. This can greatly reduce the swelling. |
Is surgery necessary?
In most cases, surgery is not necessary. Only if the above treatments do not help, will a doctor recommend surgery. This is usually a minor procedure. It involves making a small incision in the tendon sheath to allow the tendon to move freely.
How long does it take to recover after treatment?
It usually heals within a few weeks. If you have to wear a splint, you will need to wear it for several weeks.
The most important thing is, even if you feel a little better, wait until the doctor says, "Okay, start working now." Otherwise, it may come back. Don't go back to the activities that caused the pain too quickly.
What happens if left untreated?
De Quervain's is a very treatable condition. However, if left untreated, the tendon sheath can become damaged, possibly bursting, or even tearing. If that happens, you may permanently lose the ability to move your thumb and wrist. So don't ignore the pain.
Can't this situation be prevented from happening?
Yes, you can. All you need to do is reduce the pressure on your thumb and wrist.
- If you play a sport or do a job, be aware of the correct posture and technique related to it.
- When starting a new exercise or activity, start slowly.
- If you keep doing the same thing, take breaks every now and then.
- "Don't work through the pain." If you feel pain, stop the work and rest.
- Give your body time to recover after strenuous activity.
Take-Home Message
- De Quervain's Tendinosis is a condition that causes pain on the thumb side of your wrist. It is often caused by overuse of the hand.
- This can be especially common in mothers with young children, manual workers, and athletes.
- Many people can recover from this with simple treatments such as rest, ice, and wearing a splint.
- Ignoring the pain can make the condition worse. So if you have symptoms, see a doctor immediately.
- Following your doctor's instructions exactly is essential for a speedy recovery.
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