De Quervain's thumb tendinitis is a painful inflammatory condition of the tendons on the side of the wrist. Treatment options for it include conservative management and surgical treatment for pain relief.
What is thumb tendonitis?
Tendons are bands of fibrous tissue that connect muscles to bones and help in everyday activities such as running and jumping
These tendons are covered by a protective sheath that produces synovial fluid, which maintains proper glide of the tendon during movement without difficulty or pain.
One of the most common types of tendinitis is de quervain tenosynovitis, which is swelling of certain tendons at the base of the thumb on the side of the wrist, causing pain and limiting the ability to move the wrist.
De Quervain's syndrome affects the extensor brevis and abductor longus muscle. These muscles are located on the dorsal side of the forearm and travel lateral to the thumb through a fibrous-bony tunnel at the wrist called the extensor reflex.
The length of the cuff is about 2 cm, so it is at risk of snagging, especially in the event of blunt force trauma or repetitive movement.
De Quervain's inflammation affects adults between the ages of 40 and 50. This condition affects women 8 to 10 times as often as men, and is common in people with a history of medial or lateral epicondylitis.
Causes of thumb tendonitis
The exact cause of thumb tendonitis is unknown
Thumb tendinitis can be caused by several factors, including:
- Overuse
- A direct blow to the thumb, which leads to the formation of scar tissue that impedes the movement of the tendons
- Long-term physical activities such as running
- The presence of an inflammatory condition in the body, eg Rheumatoid Arthritis
- Fluid retention, which occurs in pregnant women due to hormonal changes during pregnancy
In addition, activities that require moving the wrist sideways while gripping the thumb aggravate the inflammation, and this is what happens in sports and daily activities such as:
- Racquet sports and tennis
- Use the hammer
- sewing
- Raising young children
- playing piano
Symptoms of thumb tendonitis
Symptoms of de Quervain's tendinitis can include:
- Side pain in the wrist below the base of the thumb
- wrist pain
- Mild swelling or redness and warmth in the wrist
- A fluid-filled cyst forms near the thumb
- Crackling or popping sensation in the wrist when bending the thumb
Diagnosis of thumb tendinitis
To diagnose thumb tendonitis, the doctor examines the hands to see if the patient feels pain when pressing the wrist or not.
Finkelstein test
The doctor may perform this test to detect tenosynovitis, in which the thumb is flexed at the wrist toward the ulna and covered by the remaining four fingers, then the wrist is flexed toward the ulna.
A positive result of the test causes pain along the path of the affected tendon.
Thumb tendinitis treatment
The type of treatment appropriate for the patient depends on the age of the injury, how bad the symptoms are, and is divided into conservative management, self-care, and surgical treatment.
The treatment of thumb tendinitis aims to reduce pain and swelling, preserve the motor function of the wrist, and prevent a recurrence of the inflammation.
The amount of time it takes for symptoms to improve or go away varies from person to person, depending on the nature of the patient's activities and health condition.
Conservative treatment aimed at relieving the pain of hallux neuritis includes:
struts
Wearing splints to rest and prevent movement of the wrist and thumb. A thumb splint is usually worn for four to six weeks.
Ice compresses
Putting ice on the sore thumb and wrist area for 10 minutes every 4 to 6 hours approximately helps reduce associated swelling.
Medications
Take NSAIDs such as naproxen, diclofenac, and ibuprofen to reduce pain and inflammation.
steroid injection
If symptoms persist and previous treatments fail, a doctor may inject corticosteroids into the tendon sheath. In about 70% cases, the injection helps relieve pain and swelling for a few weeks or months.
Herbal treatment of thumb tendonitis
The treatment of de Quervain's inflammation with natural herbs is characterized by the lack of side effects associated with its ability to relieve mild to moderate pain, and these herbs include: white willow, ashwagandha, turmeric, and arnica plant.
Surgical treatment of thumb tendonitis
The doctor recommends surgery to treat thumb tendinitis in the following cases:
- Persistent pain along the tendon sheath
- Suffering while moving despite trying traditional methods
- The patient's lack of response to pain relievers
- Symptoms worsening
De Quervain's tendon surgery:
It is an outpatient procedure usually performed under local anesthesia or with light sedation.
During the surgery, a small incision is made in the sheath that the tendons pass through. This allows more room for the tendons to slide easily through the sheath.
The goal of this surgery is to eliminate pain and swelling and restore movement of the thumb and wrist within the normal range.
Side effects of de Quervain surgery:
- A painful and unsightly postoperative scar is formed for several weeks, as a result of the gently displaced nerve branches of tunnel vision
- Temporary numbness in the back of the hand or thumb
- Infection (lower risk of 1%)
- stiffness and stiffness;
Upon recovery, the doctor will recommend doing wrist-strengthening exercises under the supervision of a physical therapist.
Prevention of thumb tendonitis
Thumb tendonitis can be prevented by changing activities that cause pain, taking periods of rest, avoiding activities that aggravate the condition, trying to diversify hand movements instead of taking a fixed position for long periods.
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Common questions
De Quervain's tendonitis is a common and not serious inflammatory problem. In some cases, the thumb can heal within a few weeks. However, tendinitis can also be a painful nuisance that disables the use of the hand. The pain can be relieved by taking painkillers and resting.
Inflammation of the tendons in the thumb is medically known as synovitis. It is a disease in which the patient suffers from pain that extends along the two tendons in the wrist, especially when grasping something and bending the wrist repeatedly.
Vitamin A contains a high percentage of collagen, which contributes to strengthening connective tissues, including tendons, bones and cartilage in the human body. It can be obtained from its natural sources such as carrots or from nutritional supplements under medical supervision.
