De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a condition that affects the inner side of the wrist and forearm, causing significant pain. The two tendons that pull the thumb away from the palm run through a narrow tunnel from the forearm to the inside of the wrist which holds them in place next to the bone. A lubricating coating called tenosynovium should allow the tendons to glide smoothly. If the tenosynovium becomes inflamed due to repetitive stress or injury, then soreness and swelling can occur above the thumb or wrist. De Quervain’s tenosynovitis tends to present gradually over time, but if not recognised and treated, it can become severe.

Initial treatment involves rest, hand  therapy, casts or splints, or anti-inflammatory medication. Steroid injections are used to treat more serious pain and relieve symptoms in 70% of cases, working particularly well in cases of early detection.

If it is determined that surgery is the best option, the procedure takes only 15-20 minutes and the patient can be home that day. The two tendons are released and the roof of the tunnel is cut open, allowing it to reform and heal in a manner that will allow smooth movement. During recovery, the wrist should be elevated and bandaged. Symptoms tend to improve almost immediately, but full recovery tends to take up to eight weeks.

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