De Quervain's tenosynovitis is an inflammatory condition that affects the thumb. More specifically, the condition involves inflammation of the lining of the sheath (synovium) that surrounds two tendons of the thumb: Abductor Pollicis Longus and Extensor Pollicis Brevis. The inflammation prevents the tendons from gliding smoothly through a tunnel located on the thumb side of the wrist. When the synovium of these tendons becomes inflamed friction occurs with certain thumb and wrist movements, which ultimately causes pain and discomfort.
This condition is typically caused by repetitive movements and overuse. It can also be associated with pregnancy and rheumatoid disease. Prevalence of this condition is 0.5% for men and 1.3% for women among adults.
Symptoms of De Quervain's tenosynovitis are pain over the thumb side of the wrist, either gradual or sudden in nature. Grasping, pinching, or gripping objects with the use of the thumb may aggravate the pain. Swelling and inflammation may occur over the base of the thumb at the wrist.
To diagnose this condition the Finkelstein test is often performed. This test involves placing the thumb across the palm and then making a fist with the fingers over the thumb. The wrist is then bent toward the little finger. If pain is reproduced at the thumb side of the wrist, the test is considered to be positive.
Treatment may include the use of a thumb brace or splint, rest, modalities performed by a physiotherapist to reduce pain and inflammation, and specific exercises to improve function. Repetitive thumb and wrist movements should be avoided as much as possible, as well as forceful or painful movements. Please consult with your health care provider to determine the best treatment options for your condition.
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