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INFORMATION
FOR OUR PATIENTS AND THEIR FAMILIES |
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| What is
de Quervain's Disease? |
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 Once
called Washer Woman's Sprain, this condition now bears the name of the Swiss surgeon,
Fritz de Quervain (da cur vains ) who wrote about it in 1895.
De
Quervain's disease is a painful inflammation of the tendons in
the wrist. From
the drawing on the right, one can see that the tendons connected
to the thumb bones are encased in lubricated sheaths, or sleeves,
through which the tendons slide. With repetitive or excessive movements such as hand twisting and
forceful gripping, the lubrication system may malfunction which allows friction to develop between the tendons
of the thumb and their common sheath. The repetitive friction causes
tendon thickening which
interferes with the smooth gliding motion as these tendons are called
upon to move the thumb.
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| What
causes De Quervain's Disease? |
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| De Quervain's disease
is caused by anything that causes swelling or thickening of the
tendons. Repetitive trauma, overuse, or an inflammatory process
are likely causes, but frequently, the cause of the disease is
unknown. In other cases, scar tissue from an injury to the hand
can make it difficult for the tendons to slide easily through
their sheaths. |
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| Who
gets De Quervain's Disease? |
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De Quervain's disease
occurs most often in individuals between the ages of 30 and 50.
Women are afflicted with it 8 to 10 times more often than men.
People who engage in repetitive activities requiring sideways
motion of the wrist while gripping the thumb, as in hammering,
skiing, some assembly line jobs, etc., may be predisposed to
developing this disorder.
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| What
are the symptoms of De Quervain's Disease? |
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Pain over the
thumb side of the wrist is the primary symptom. It may
occur either suddenly or gradually, and it may radiate
into the thumb and up the forearm. It may become worse
as the thumb is moved away from the hand, and becomes
more intense with the use of the hand and thumb,
especially with any forceful grasping, pinching, or
twisting. Swelling over the thumb side of the wrist may
be present, as well as some "snapping" when
the thumb is moved (caused by the tendons moving through
the constricted sheaths. Because of the pain and
swelling, there may be some decreased thumb motion. |
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| How
is De Quervain's Disease diagnosed? |
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| Our doctors usually
diagnose de Quervain's disease with a physical examination. Most
of the time no additional tests are required. |
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| What
is the treatment for de Quervain's disease? |
If at all possible, you must change
or stop all activities that cause your symptoms. Take frequent
breaks when doing repeated hand and thumb actions. Avoid
repetitive hand motions such as heavy grasping, wringing, or
turning and twisting movements of the wrist. Keep the wrist in a
neutral alignment. In other words, keep it in a straight line
with your arm, without bending it forward or backward.
Our
doctors may first try to reverse the course of the disease with
a 3 to 6 week trial on an anti-inflammatory medication while the
thumb and wrist are rested by wearing a wrist and thumb splint.
He may also inject the inflamed area with a steroid to help
decrease the inflammation. If
all else fails, you may need surgery. The goal of surgery is to
give the tendons more space so they no longer rub on the inside
of the tunnel. To do this, the surgeon performs a surgical
release of the roof of the tunnel. This is usually performed
on an outpatient basis.
A prescription for pain medication will be provided following
surgery. You should expect some pain, especially the first three
days. The bulky dressing is removed at one of our offices a few
days after surgery, and an exercise program for the thumb and
wrist is started. It is important to do the exercises as
prescribed. De Quervain's disease rarely recurs after proper
surgical intervention. Complications may occur if not treated. |
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