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What is De Quervain's Tenosynovitis?

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  • Written By: Jacob Queen
  • Edited By: Lauren Fritsky
  • Last Modified Date: 14 September 2016
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De quervain's tenosynovitis is a disorder caused by inflammation that generates pain on the inner part of a person’s wrist in the area beneath the thumb. This disorder is generally caused by repeated awkward movements of the thumb over a long period of time. These movements damage the pathways of important tendons in the wrist and thumb area, thereby resulting in inflammation. De quervain's tenosynovitis is normally curable, although treatment may require lifestyle changes and special precautions.

There are muscles on top of the forearm that generally control finger and thumb movement. These muscles are attached to tendons that travel through tunnels in the bones of the arms and hands. There is a lubricated surface inside the tunnels called tenosynovium that keeps the tendons moving smoothly. When the tenosynovium becomes inflamed, it can swell, which makes it painful for a person to move his thumb.

For some people, the inflammation can actually make the surface of the skin red, and for others it may even cause visible swelling. The pain from de quervain's tenosynovitis can become so severe that the individual may be temporarily disabled and forced to miss work. This pain usually builds up gradually over time, generally starting as a small inconvenience and slowly increasing in severity as awkward thumb movements continue to injure the area. If the thumb movements stop, sometimes the condition can recover on its own without any medical treatment.

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When doctors diagnose de quervain's tenosynovitis, they will normally ask patients to wear some kind of wrist brace. Doctors may also find out as much as possible about the working conditions of patients and ask them to change the way they perform certain activities with their hands. Once treatment is started, it can sometimes take several weeks for all the symptoms to abate. When the symptoms finally disappear, patients are always at risk of redeveloping the problem, so future diligence may be required in terms of activities performed with the hands.

One common treatment is to inject patients with cortisone, and this can often greatly reduce any inflammation in the area. Sometimes this doesn’t work, although the success rate is generally very high. For patients who can’t recover normally, doctors may choose a surgical option. This normally involves making a crack in the bone tube that the tendons travel through, which will result in a wider opening and allow the tenosynovium to heal. Surgery is generally avoided if possible because the rehabilitation can be lengthy and painful, with a long period of reduced physical functionality.

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