What is DeQuervain’s tendinitis?shutterstock_170987189

Dequervain’s tendonitis is inflammation of the tendons which travel on the thumb side of the wrist.  This type of condition is related to inflammation of the two tendons that pass over the top of the thumb and allow the thumb to extend and pull away from the palm.  We often see this condition in new mothers as they are constantly extending their thumbs and moving it out from the palm as they pick up their small child.

What are the symptoms of Dequervain’s tendinitis?

People complain of pain at the base of the thumb and wrist.  Activities that require pinch and tight gripping can elicit the pain. The pain will often extend up into the forearm.

How is Dequervain’s tendinitis diagnosed?

It is most often diagnosed by history and physical exam.  On occasion, an X-ray will be ordered to rule out arthritis at the base of the thumb.

What is the treatment for Dequervain’s tendinitis?

In most cases, the initial treatment is non-operative.  A trial of splinting and steroid injections is attempted at first.  Most patients, approximately 70%, will respond to injection and won’t need surgery.  If the response to injection is suboptimal or short lived then the patient will need surgery.

What does surgery for Dequervain’s tendinitis involve?

Surgery for Dequervain’s tendonitis involves releasing the sheath through which the irritated tendons glide.  This release decreases the friction between the tendons and prevents inflammation.

What are the main risks of this surgery?

• Swelling, stiffness, and pain
• Infection
• Nerve Damage
• Tendon damage
• Recurrence

Post Operative Course

Day 1-14
• Keep dressing/splint clean and dry
• Elevate hand above heart level for first 48 hours to prevent pain and swelling
• Move other digits in the hand to prevent stiffness

Day 14-3 months
• Splint will be removed and hand therapy started
• Continue to progressively use your hand
• Expect near full usage of thumb by 8 weeks

Driving?
You may drive when you are off narcotics and feel confident to control the car.  Most patients are able to drive within a week.

Time off of Work?
This is dependant on the type of work you perform.  Many patients with office jobs only require a few days.  However, patients who perform heavy labor may require 4-5 weeks to recover.