de Quervains Tenosynovitis

What is tenosynivitis?

Tenosynivitis is inflammation of the sheath that surrounds a tendon as opposed to inflammation of the actual tendon itself (tendinitis or tendonitis). de Quervain's tenosynivitis is inflammation of the synovium of the abductor pollicis longus and extensor pollicis longus muscles as they pass through the wrist (on the thumb side of the wrist). It occurs more frequently in racket sports such as tennis, squash or badminton as well as canoing and ten pin bowling. It also occurs in golfers (left thumb of a right handed golfer and vice versa). Tendon injuries such as this are often labelled with the umbrella term RSI (repetitive strain injury).

Symptoms of de Quervain's tenosynovitis

• Tenderness and swelling on the thumb side of the wrist where the tendons pass.
• Creptius may be felt (a creaking of the tendon as it moves).
• Finkelstein's test may be positive (thumb is placed in the palm of the hand and wrist moved laterally towards the little finger to stretch the tendons - pain may be felt).

Treatment

• Rest, splinting if necessary.
• Using an extra thick pen may help as this reduces the stretch on the tendons when writing.
• Ice or cold therapy to reduce pain and inflammation.
• Ultrasound
• Stretching and strengthening.
• A cortisone injection may be given.
• In rare cases surgery may be indicated.