De Quervain’s syndrome

What is De Quervain’s

De Quervain’s is a common condition leading to pain around the wrist and thumb, which can significantly impede normal daily activities. The good news, however, is that the condition is very rarely serious and there are things that you can do to set you up for a successful recovery.

It affects the muscle tendons where they run through a tunnel on the thumb side of the wrist. These tendons arise from muscles in the forearm and then run together through a sheath (tunnel) that keeps them close to the bone as they cross over from the thumb side of the wrist into the hand. Tendons are rope-like structures that attach muscle to bone, allowing the muscle to pull on and move the bone. Tendons are covered by a slippery and thin soft-tissue layer called synovium. Irritation of the tendons/ synovium and/or swelling of the sheath can lead to pain with certain thumb and wrist movements.

Symptoms may include:

• Pain and tenderness at the base of the thumb /on the thumb side of the wrist.
• Pain may sometimes radiate up the forearm.
• There may be swelling around the site of pain – you can compare this with the same spot on the opposite wrist.
• The pain is usually worse when the hand and thumb are in use.
• Pain is often felt by repetitive lifting, gripping, or twisting motions of the hand or thumb. Common activities which can be painful include using your painful hand to pour from a heavy kettle, opening a jar lid, wringing out a dishcloth, cutting with scissors, playing the piano or doing fine craft work.
• Occasionally it can make a clicking sound or there may be a catching sensation.

Factors that may play a role in the development of De Quervain’s syndrome include:

• A sudden increase or change in activity levels. Particularly activities which repeatedly use the hand and wrist such as an increase in tasks like gardening, using a gamsole or D.I.Y.
• It is a very common problem in new mothers,  although it is not clear whether this is due to hormonal changes or the repeated lifting of the newborn child.
• It can also be associated with pregnancy and breastfeeding.
• It is most common in people in their 40s and 50s.
• Having certain health conditions such as hypothyroidism and rheumatoid arthritis.
• Being overweight, particularly weight around the middle.
• Lifestyle factors such as being sedentary or smoking.
• De Quervain’s can also be triggered by life changes, including periods of stress, illness or the feeling run down.
• It tends to be more common in people who have had tendon problems in their upper limb before (e.g. tennis elbow or golfer’s elbow).