De Quervain Tenosynovitis โ Diagnosis and Treatment
Diagnosis
Ways Providers Check for the Condition
Doctors usually ask about your symptoms and review your medical history. During a physical exam, they press on the thumb side of your wrist to check for pain or swelling.
One common test is the Finkelstein test. In this test, you place your thumb across your palm, wrap your other fingers around it, and bend your wrist toward your little finger.
If you feel pain during this movement, it often means the tendon sheath of the abductor pollicis longus and extensor pollicis brevis is inflamed.
Doctors rarely use imaging like MRI or X-rays, since your symptoms and exam usually provide enough information.
Treatment
Medicines to Reduce Pain and Swelling
Doctors often begin with medicines to ease swelling and relieve pain. Over-the-counter options like ibuprofen or naproxen sodium can help with these symptoms.
These drugs are NSAIDs (nonsteroidal anti-inflammatory drugs). They reduce inflammation and help you feel better.
If pain and swelling do not improve, your doctor may suggest a corticosteroid injection into the tendon area. This shot can quickly decrease swelling.
Many people improve after just one injection, especially if they receive it within the first six months after symptoms start.
Supportive Treatments and Physical Activities
Early treatment often includes rest and supportive care. Wearing a splint or brace to keep your thumb and wrist straight helps the tendons rest and heal. Avoid movements that repeat or strain the thumb, such as pinching or twisting.
Applying ice to the area can help lower swelling and pain.
Physical therapists or occupational therapists can teach you gentle exercises to strengthen your wrist and hand muscles. They also show you how to use your wrist safely at home and work. This guidance helps prevent the problem from returning.
Simple support strategies:
- Rest the affected hand and wrist
- Splinting for several weeks
- Ice packs to reduce swelling
- Therapeutic exercises under guidance
Surgical Options and Alternative Procedures
If other treatments do not solve the problem or if symptoms are severe, surgery may be necessary. The surgeon makes a small cut and opens the tendon sheath, which lets the tendons move freely and relieves pressure.
After surgery, your care team creates a recovery plan. This often includes new exercises and advice on how to avoid stressing the area. Physical or occupational therapy usually helps you regain strength and prevent future issues.
Everyday Care and Helpful Practices
Taking breaks and avoiding repeated wrist motion can help reduce pain. Wearing a brace or splint may help if your health provider recommends it.
Simple steps include:
- Noticing which activities cause discomfort in your thumb or wrist
- Limiting or avoiding those actions
- Doing gentle exercises as recommended
A table of common advice:
| Action | Purpose |
|---|---|
| Rest wrist and thumb | Reduce strain |
| Wear a brace or splint | Support joint |
| Follow exercise plan | Improve movement |
Getting Ready for Your Visit
How to Prepare Before Seeing Your Doctor
You can take a few simple steps to get the most out of your health care visit:
List Your Medical Details: Write down your medical conditions, allergies, and any prescription or over-the-counter medications or supplements you use.
Gather Activity Information: Note any activities such as knitting, gardening, playing music, or sports that might stress your hand or wrist.
Record Recent Injuries: List any recent injuries to your hand or wrist, even minor ones.
Prepare Your Questions: Write down questions for your medical team. For example:
What might be causing my symptoms?
Are there other possible causes?
Do I need tests to find the reason for my pain?
What treatments should I try?
How does this affect my other health problems?
Will I need surgery?
How long should I rest my hand or wrist?
- What else can I do at home to help myself?
Ask about anything that is unclear, and add your own specific concerns.
Questions Your Doctor May Ask
During your appointment, your doctor will likely ask about your symptoms and daily life.
Typical questions may include:
- What kind of pain or symptoms do you have? When did they begin?
- Have your symptoms changed over time?
- Which activities or movements make your symptoms worse?
- Do you have hobbies or play sports that involve repeated hand or wrist use?
- What is your job? What tasks do you perform?
- Have you had any recent injuries to your hand or wrist?
- Does avoiding certain activities help your symptoms?
- Have you tried any home remedies or medications? Did they help?
If you prepare to answer these questions, your healthcare provider can better understand your situation and guide you to the right treatment.
