De Quervain's
De Quervain’s is a type of tendonitis that causes pain when you move your wrist and thumb, and usually a tender swelling at the base of your thumb.
The two tendons that move your thumb usually glide freely through a tight tunnel or sheath at the base of your thumb.
If the fibrous roof of the tunnel thickens, the tunnel becomes too tight resulting in pain when you move your wrist and thumb. Sometimes your wrist and thumb may lock slightly when you move it.
De Quervain’s can be caused by taking up a new very repetitive activity. An injury to the area can also bring on the symptoms.
What treatments are available for De Quervain’s?
Your consultant may recommend resting your wrist and thumb by using a special splint to be worn day and night. You may receive physiotherapy. Anti-inflammatory medication may reduce the pain.
A steroid injection into the base of your thumb can be a very effective way to treat De Quervain’s.
In cases where none of the non-surgical methods provide sufficient relief your consultant may recommend surgery.
What happens during surgery for De Quervain’s
Surgery for De Quenvain’s involves making more room the tendons to glide freely through the tunnel. This operation can be performed using a variety of anaesthetics. Your surgeon will make a small incision (cut) at the base of your thumb. They will then cut open the fibrous roof of the tunnel that is causing the De Quenvain’s tendonitis.
This operation is usually performed as a day case meaning you will be able to go home the day of your surgery. You will not be able to drive so please arrange for someone to take you home.
Going home after surgery
Your scar may be sore and swollen for a few days. You should rest and elevate your hand to relieve the swelling. You may be asked to wear a splint full time for the first two weeks. You may be given gentle exercises to reduce stiffness and build up strength.
Most people make a good recovery and return to normal activities following surgery for De Quervain’s. As with any surgery there can be complications:
- Pain
- Bleeding
- Infection of the surgical site (incision)
- Scarring
Specific complications of surgery
- Numbness at the back of your thumb
- Tenderness of the scar
- Thumb tendon moving out of place
- Complex regional pain syndrome - a condition that causes long-term (chronic) burning pain in one of the limbs.