Sep 22, 2020
As someone who has suffered from this condition, it can be rather debilitating.
What is it?
De Quervain’s tenosynovitis is a condition when two extensor tendons along the radial aspect of the wrist become inflamed. These two tendons, the abductor policies longus and extensor pollicis brevis, span the first dorsal extensor compartment of the wrist.
Who gets it?
New moms are particularly susceptible to this condition due to the repetitive nature of lifting their newborn. Also affected are those who engage in repetitive wrist activities, including golfers, gardeners, and musicians, to name a few.
What are the symptoms?
Many experience a sharp pain along the radial aspect of the wrist, extending throughout the thumb. Those who experience a locking or clicking sensation at the affected area carry a worse prognosis. Symptoms occur primarily with thumb and wrist movement while ulnar deviating the wrist, such as when holding a newborn, lifting a dish, or opening a jar. The thumb is involved because one of the two extensor tendons, the extensor pollicis brevis, attaches to the base of the thumb.
What are the treatment options?
Initial treatment options include oral
or topical anti inflammatory medication, with an over the counter forearm based thumb spica Velcro splint. If those prove to be ineffective, a corticosteroid injection would be the next line of treatment. If symptoms prove to be refractory to a corticosteroid injection, then surgical intervention is indicated.
What does the surgery entail?
Surgery involves making a small incision along the radial aspect of the wrist in order to release the first dorsal extensor compartment. This surgery is outpatient, performed under a local anesthetic, and typically takes no longer than 20 minutes. A soft dressing is applied, and sutures are removed approximately 10-12 days later. Many resume normal activity, including caring for their newborn, driving, and sedentary work within the first 24 hours.
After failing multiple corticosteroid injections, I ended up undergoing surgical intervention on both wrists approximately 6 years ago while living in New York. To this date, I’ve had no issues, and resumed routine activity, including yoga, golf, and paddle boarding without difficulty.
If you feel you are suffering from this condition, please contact our office for an initial evaluation.