It is known as Quervain’s tendinitis, the painful syndrome of the wrist , which affects the tendons at this level, is generated by inflammation of the two tendons that surround the base of the thumb (tendons of the abductor pollicis longus and the extensor pollicis brevis) , this generates pressure on the nerves, which translates into pain when turning the wrist, taking any object, even when closing the hand.

It is an increasingly frequent pathology, because many activities involve repetitive movements in the wrist, it is more frequent in women, particularly after 40 years.

7 causes of Quervain’s tendonitis

The exact etiology of this painful wrist disease is unknown, what is known is that certain repetitive flexion and extension movements of the wrist can exacerbate the clinic, such as: garden work, document transcription, some sports such as Tennis or ping pong, lifting, even common activities like lifting your baby can cause pain.

1. Repetitive movements

Constant flexion, extension and rotation of the wrist is the factor most frequently associated with the appearance of De Quervain’s tendonitis , since it involves a repetitive ulnar or radial deviation of the wrist, this causes inflammation of the tendons and pain.

2. Scar tissue

In the cases in which injuries of the previously described tendons are generated, with formation of fibrous tissue that limits the movements of the wrist and also causes inflammation, it can be one of the causes of this pathology.

3. Pregnancy

The hormonal changes described in pregnancy can cause the appearance of pain in the wrist.

The de Quervain ‘s tenosynovitis is a common condition in new mothers. It is defined as inflammation of the tendons of the thumb in the wrist area. At this level, the tendons are surrounded by a fluid-filled synovial covering under which they should be able to slide freely.

This cover reduces friction with the bones. The pain often comes on gradually over a few weeks and limits wrist movements.

The pain can become very sharp and radiate to the forearm. The area of ​​pain can sometimes be swollen. Attempting to hold the baby will increase pain and prevent the bro from being able to move precisely. The area will also be tender to the touch. Mom may also notice a decrease in strength, numbness, or a burning sensation.

4. Rheumatological diseases

As is the case with rheumatoid arthritis, which causes tendons to be affected, causing this painful wrist syndrome .

5. Injuries to the wrist

Lesions that can generate local inflammation and functional limitation associated with de Quervain’s tendonitis.

6. Sports that involve constant wrist movements.

Some sports, such as tennis, rowing, or golf, that involve constant movements of the wrist can cause injuries, among which is Quervain’s tenosynovitis.

7. Cargo handling

Lifting, dragging or pushing loads constantly stimulates the appearance of micro-injuries to the wrist, which are part of the causal factors of this pathology.

Quervain’s tendonitis treatments

The treatment of this disease is aimed at reducing pain and / or inflammation, in order to regain the functionality of the affected wrist, this includes: conventional, pharmacological and surgical measures:

  1. Use local heat or ice in the affected area:  As a factor that leads to the reduction of local pro-inflammatory factors, thus helping to reduce pain.
  2. Use of non-steroidal anti-inflammatory drugs (NSAIDs):  Due to their mechanism of action, they reduce pain and inflammation in the wrist.
  3. Try to rest the affected area:  Avoid repetitive wrist movements that generate pain and local inflammation.
  4. Use an immobilizer that includes the thumb and wrist:  In order to give rest to the affected tendon bundle. The orthopedic splint is essential to keep the thumb motionless next to the wrist.
  5. Local injections of steroids and NSAIDs: Their effectiveness will depend on the regularity of their use and tolerance to the drug.
  6. Occupational therapy : Indicates the process of receiving education about wrist movements that allows you to relax the tendons and strengthen the muscles.
  7. Surgery: In severe cases where, through medical treatment and physiotherapy, the pain of Quervain’s tendonitis persists , after 6 weeks, surgical resolution is recommended, which is an outpatient procedure, which consists of inspecting the sheath that cover the tendons and open it to release pressure, thus allowing the tendons to move freely.

Summarizing:

  • Tenosynovitis is a diagnosis that should be considered when a patient has pain along a tendon pathway with mobility that is not free and complete, especially at the level of the fingers, wrist, or ankle.
  • Faced with a clinical suspicion of tenosynovitis, ultrasound is an accurate way of studying, both to confirm the diagnosis and to guide a puncture or infiltration.
  • Diabetes is a risk factor and a poor prognosis for tenosynovitis.
Dr. Eric Jackson

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses. He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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