The tendons of the abductor pollicis longus and extensor pollicis brevis pass through a narrow canal formed by a groove of the radius bone and a strong ligament. In certain thumb movements, these tendons rub against the bone, leading to inflammation. Swelling of the tendons, their sheath, and the tendon compartment causes pain and tenderness on the thumb side of the wrist. This discomfort is particularly noticeable when making a fist, gripping objects, or rotating the wrist.
Although the exact cause of de Quervain’s Disease is unknown, any activity involving repetitive hand or wrist movements, such as gardening or racket sports, may aggravate the condition. de Quervain’s Disease is more common in middle-aged women. It may also occur after pregnancy and during breastfeeding, likely due to hormonal changes, and it is often associated with inflammatory arthritis, such as rheumatoid arthritis.
The main symptom is pain at the wrist, near the base of the thumb, with localized tenderness over the radial styloid process. The pain may appear gradually or suddenly and typically worsens with hand and thumb use, especially when gripping objects tightly or twisting the wrist. Swelling and redness may also be present at the site of tenderness. Other wrist conditions, such as basal thumb joint arthritis or injury to the superficial radial nerve, can produce similar symptoms.
Two specific clinical tests are commonly used to diagnose de Quervain’s Disease. The Finkelstein test provokes sharp pain at the radial styloid when the physician grasps the patient’s thumb and applies traction with ulnar deviation of the wrist. The Eichoff test produces similar pain when the patient encloses the thumb in the palm and the physician forces ulnar deviation of the wrist.
Imaging studies, such as X-rays, are usually not necessary to diagnose de Quervain’s Disease.
In the early stages of de Quervain’s Disease, conservative management is often effective.
Anti-inflammatory medications help reduce swelling and pain, but local corticosteroid injections typically provide better results. Alongside medication, a splint is often applied to immobilize the thumb and wrist while leaving the other fingers free, typically for two to four weeks.
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If conservative treatment fails or if symptoms recur within a short period, surgery is recommended. Under local anesthesia, a small two-centimeter incision is made to release the tendons, relieving the restriction.
The best way to prevent de Quervain’s Disease is to avoid repetitive wrist and thumb movements. Activities that strain the wrists should be minimized, frequent breaks should be taken, and a splint can be used when necessary. Stretching exercises for the wrist and fingers, as well as strengthening exercises, are also beneficial.
de Quervain’s Disease is an inflammation of the thumb tendons caused by repetitive movements.
The main symptoms are wrist pain, swelling, and difficulty moving the thumb.
Treatment includes immobilization, anti-inflammatory medications, and in severe cases, surgery.
With proper treatment, recovery is usually achieved within four to six weeks.
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