De Quervain's Disease

[Guest guest]

Hi Dawn.. Here is some info from 3 different web sites. The last site is

the best in term of pictures. The pain in the thumb and makes the whole hand

hurt. Movement an lifting are painful. I has a whole summer of both hands in

braces.

Hope this info helps. Priscilla

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De Quervain's Disease

Related Terms: . Tendonitis . Synovitis . Trigger Finger

Definition: De Quervain's Disease is a syndrome that causes pain associated

with movement of the thumb. The cause of the pain is inflammation within a

confined area around the base of the thumb and wrist. This inflammation is

called 'stenosing tenosynovitis.' This simply means that the inflammation

involves the synovium and tendons that control the movement of the thumb.

De Quervain's Disease is most common in the 30-50 year old age group, and is

seen more commonly in women. De Quervain's Disease is due to excessive use

of the wrist, and more commonly seen in individuals with arthritis.

The tendons are surrounded by a slippery sac called a tenosynovium which

allows the tendons to move smoothly. If the tenosynovium becomes inflamed

because of overuse (tenosynovitis), the tendons will not glide easily with

movement, and use of the thumb becomes painful.

Treatment begins with anti-inflammatory medications and rest of the thumb,

these measures are aimed at minimizing inflammation. Often placing the thumb

in a splint will relieve stress on the inflamed area and minimize pain

associated with movement. Steroid injections can also be used to control the

local inflammation. If these treatments do not relieve the pain, surgery can

be performed to 'release' the confined area. This allows for less

constricted movement of the tendons, and usually alleviates inflammation.

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De Quervain's disease

Also known as: de Quervain's syndrome; de Quervain's tendinitis

Synonyms:

Congenital clasped thumb, flexor pollicis longus stenosing tendovaginitis,

pollex vatus; snapping thumb syndrome, stenosing tendinitis of the abductor,

tendovaginitis stenosans, tenosynovitis, trigger thumb.

Associated persons: Harry Finkelstein Fritz de Quervain

Description:

Chronic tenosynovitis due to a narrowing process in the tendon sheaths

around abductor policis longus and extensor pollicis brevis muscles. The

disease causes pain, swelling, and tenderness. In adults, in addition to the

thumb, other fingers may be involved; in children, limited to the thumb.

Adults report a snapping phenomenon in the distal interphalangeal joint.

More frequent in adults (prevalent in females) than in children (equal sex

distribution); insidious onset.

The Finklestein Test is used to make the diagnosis. See under Finklestein.

Bibliography:

F. de Quervain: Über eine Form von chronischer Tendovaginitis.

Correspondenz-Blatt für Schweizer Aerzte, Basel, 1895, 25: 389-394.

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See this site it has great pictures: http://www.e-hand.com/hw/hw008.htm

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What is it?

DeQuervain's tendinitis is a painful problem which results from irritation

of tendons on the side of the wrist which move the thumb sideways away from

the palm. It can result in wrist and forearm pain on the side of the thumb,

particularly with certain positions and movements of the wrist.

What caused it?

It is most often noticed after unaccustomed activity involving repeated

lifting or side to side motion of the wrist. It can also develop for no

clear reason. The problem is due to irritation of two tendons at a point

where they run through a very tight channel ( " the first dorsal compartment " )

from the forearm to the thumb. Many people have two small separate channels

for the tendons and are particularly predisposed to this problem.

What can you do to help?

Avoid wrist positions and activities which are painful, if possible.

Ice for five to fifteen minutes at a a time on the area which is most

swollen and tender.

" Over the counter " non-steroidal anti-inflammatory medication (NSAID), such

as aspirin, ibuprofen, naprosyn, or ketoprofen.Check with your pharmacist

regarding possible side effects and drug interactions.

A splint or brace which supports both the wrist and the thumb. A wrist

support splint which doesn't support the thumb is not as effective as one

that does.

Wait and watch.

What can a therapist do to help?

Provide a variety of hand splints to support the thumb and the wrist.

Help identify aggravating activities and suggest alternative postures.

Massage, heat, ice and other treatments aimed at making the area more

comfortable.

What can a doctor do to help?

Confirm that this actually is the problem.

Prescribe stronger NSAID medication or cortisone-type medication.

Prescribe hand therapy and/or a custom prescription splint.

Give a cortisone shot into the area of the most irritation.

Perform surgery to enlarge the tight channel so that the tendons no longer

chafe.

How successful is treatment?

Many people with mild symptoms will improve with a limited period of

anti-inflammatory medication and avoiding painful activities, especially if

the problem developed during unaccustomed strenuous activities. It is less

likely to resolve if it is related to light repetitive work activities.

A cortisone shot into the sore area helps most people - at least

temporarily. When temporary, relief usually lasts about two months. One or

two shots provide permanent relief for as many as two out of three people

with this problem.

Surgery helps over four out of five people with this problem, but as many as

one out of five will have a new problem after surgery, such as numbness on

the back of the hand or tenderness of the scar.

What happens if you have no treatment?

It depends on how much it is bothering you - it really is a quality of life

issue. This is not a problem which can spread to other parts of your body or

which must be treated within a limited period of time. Some people will have

a mild problem which flares up from time to time, and treat it themselves or

ignore it, others will have a severe problem which prevents them from doing

many things with their hand, and feel that they have no choice but to have

surgery.

Click here to search the web for deQuervain's tendinitis

American Society for Surgery of the Hand Patient Education Brochure:

deQuervain's Tendinitis

Orthogate's: A Patient's Guide to DeQuervain's

All HandWorld patient information brochures are free on line at

http://www.handfacts.com

All text and graphics Eaton MD http://www.e-hand.com