De Quervain's tenosynovitis

De Quervain's tenosynovitis is a painful condition that affects the tendons of the wrist. It occurs when the two tendons around the base of the thumb become inflamed. The inflammation causes the sheaths (wrappers) that cover the tendons to become inflamed as well. This puts pressure on nearby nerves, which causes pain and numbness.

In these circumstances the movements made with the thumb will produce pain and discomfort, which will lead to an alteration of the function of the hand, decreasing the performance to perform tasks with it. As long as the inflammation persists, the movements of the hand will lead to this lesion being perpetuated in time.

The diagnosis is imminently clinical looking for the characteristics previously described. It is important to perform a complete examination to rule out other causes of pain such as metacarpal trapezius osteoarthritis or "rizarthrosis".

The patient's study is completed with radiographs of the hand, which will not rule out or diagnose the presence of osteoarthritis in the joints, since, in general, in Quervain's Tenosynovitis the radiography is not altered.

The soft tissue ultrasound is a suitable method to confirm the diagnosis, always considering that this method is a dependent operator, so you should follow the recommendations of your treating doctor to define who and where the test should be performed.

In the first phase the treatment focuses on the medical management of the pathology, using anti-inflammatories and rest of the affected hand using a thumb immobilizer. In general, good results are obtained in 7 to 10 days, but patients complain about the discomfort caused by the immobilization of the thumb and usually do not have a good tolerance to treatment.

You may need surgery if your case is severe or if other treatments do not relieve your pain. During outpatient surgery, the surgeon makes a small cut in the sheath that surrounds the swollen tendons. This provides more room for the tendons to move.

After surgery, you will need to do physical therapy to strengthen your wrist and thumb. This will prevent the problem from coming back. Once the area has completely recovered, you will be able to use your hands normally again.