What is de Quervain’s Syndrome?
de Quervain’s tendonitis (DQT) is a common painful disorder of the wrist. It was known as “wash-woman’s wrist” and now as “new mommy wrist” and “gamer’s wrist” due to the prevalence encountered in these groups.
The condition was named after a Swiss surgeon Fritz de Quervain, who incidentally, was famous for his work on thyroid disease and the public introduction of iodine into table salt decreasing the incidence of “goiters” (swollen thyroid glands) in Switzerland. The U.S. adopted this policy in the 1920s starting in the iodine deficient Midwest where goiters affected 20-30% of the population.
DQT describes an inflammatory condition affecting two tendons on the thumb side of the wrist. These tendons are encased in a tight non-expansile tunnel. Therefore, if the tendons or tendon sheaths surrounding them swell, limitations and severe pain may follow.
DQT can occur from a direct blow or from overuse episodes including wrist twisting and gripping activities from pruning in the garden, gaming with a hand controller, or from twisting baby bottle tops.
The classic physical findings on exam include swelling and localized tenderness to the thumb side of the wrist. A positive Finkelstein’s test is usually provoked by placing the patients thumb in the affected hand and moving the wrist away from the thumb.
The treatment of DQT may include home remedies such as deferring from the inciting activity, icing, and a splint to immobilize the wrist and thumb. OTC medications such as ibuprofen or naproxen may help.
Conditions that may mimic DQT may include arthritis of the thumb or wrist, and wrist fractures.
For cases that are severe or those that do not respond to at home treatment, make an appointment with an orthopedist to make sure of the correct diagnosis. Treatments may include more rigid splinting or bracing, prescription strength anti-inflammatory medications, a corticosteroid injection, physical therapy, and in a few cases an outpatient minor surgery to release the tendon sheath.
If you have a painful orthopedic condition, please reach out to my friendly staff to make an appointment with myself or my associate Michelle Mesh. Be sure to make an appointment with us: http://robertmoriartymd.com/contact-us/ or 631-423-BONE (2663).