De Quervain’s Tenosynovitis: Causes, Symptoms, and Treatment Options In Singapore

De Quervain’s tenosynovitis, or De Quervain’s Syndrome, is a painful condition that affects the tendons along the thumb and that side of the wrist. When the tendons at the base of the thumb become inflamed due to trauma or excessive use, it can cause pain while moving the thumb and also while making different hand and wrist movements. This condition commonly affects individuals who engage in repetitive wrist and thumb motions, such as lifting, grasping, or pinching. Early diagnosis and treatment can help manage symptoms and prevent further complications. In this guide, we discuss the details of De Quervain’s syndrome, how it is caused, its symptoms, and treatment options.

What Is De Quervain’s Tenosynovitis?

To understand what De Quervain’s tenosynovitis is, it is important to understand the wrist’s anatomy first.

Our wrist is a complex joint that comprises eight small carpal bones, multiple ligaments, tendons, and soft tissues that enable a wide range of motion. The wrist contains several tendon compartments, each compartment comprising the tendons that aid in hand and finger movement. These tendons pass through a narrow sheath on the radial side of the wrist. When the tendons in the dorsal (back) side of the wrist get inflamed, they cause pain, swelling, and restricted movement of the thumb and wrist, leading to conditions like de Quervain’s tenosynovitis.

This condition is often associated with repetitive stress, overuse, or direct injury to the wrist, leading to discomfort when gripping, twisting, or lifting objects. Learn more about wrist injury and its treatment.

Causes of De Quervain’s Tenosynovitis

There can be several causes of de Quervain’s syndrome, including:

• Repetitive Hand and Wrist Movements – Frequent gripping, pinching, lifting, or twisting motions can strain the tendons.
• Overuse or Strain – Activities such as typing, gaming, knitting, or playing musical instruments increase the risk.
• Pregnancy and Postpartum Changes – Hormonal changes and frequent lifting of infants can contribute to inflammation.
• Arthritis – Conditions like rheumatoid arthritis or osteoarthritis can cause inflammation in the wrist tendons.
• Direct Injury – A previous wrist injury may lead to tendon irritation or scarring.
• Gender and Age – Women, especially between the ages of 30 and 50, are more commonly affected.
• Fluid Retention – Swelling due to pregnancy, hormonal imbalances, or certain medical conditions can contribute to tendon irritation.

Symptoms of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis symptoms usually develop gradually but can worsen over time. Common signs include:

• Pain and Tenderness – Localised pain on the thumb side of the wrist, which may radiate up the forearm.
• Swelling – Puffiness around the base of the thumb and wrist.
• Difficulty Moving the Thumb – Pain with gripping, pinching, or twisting motions.
• Difficulty Bending the Thumb – Difficulty or an inability to bend the thumb.
• Clicking or Sticking Sensation – The thumb may feel stuck or make a snapping sound when moved.
• Weakness in the Hand – Reduced grip strength, making it difficult to hold objects.

Pain typically worsens with activities that involve gripping, twisting, or lifting, such as turning doorknobs, opening jars, or lifting a child.

Diagnosis of De Quervain’s Tenosynovitis

A specialised doctor in Singapore typically diagnoses de Quervain’s tenosynovitis through the following exams:

• Medical History – Your doctor will take your detailed medical history to review symptoms, daily activities, and potential risk factors. This can enable him to determine the actual cause of the problem.
• Physical Examination – The doctor will then conduct a physical exam to check for pain and swelling. The doctor may ask you to move your thumb and hand in certain positions to check for restricted or painful movement.
• Finkelstein Test – This is a diagnostic test where the patient makes a fist with the thumb tucked inside the fingers and bends the wrist towards the little finger. This is a diagnostic test for de Quervain’s syndrome.  Pain during this test indicates the person is suffering from de Quervain’s tenosynovitis.
• Imaging Tests (if necessary) – in some severe situations, the doctor may recommend an ultrasound or MRI scan to diagnose the condition or rule out other issues. 

Treatment For De Quervain’s Tenosynovitis In Singapore

De Quervain’s tenosynovitis treatment in Singapore focuses on reducing pain and inflammation and restoring mobility to the thumb and wrist. Depending on the severity of the symptoms, the doctor may opt for non-surgical or surgical treatment options:

Non-Surgical Treatments

For the usual cases of de Quervain’s syndrome, the first line of treatment involves conservative treatment measures, including the following:

• Rest and Activity Modification – The first and most important measure that doctors advise is to avoid repetitive thumb and wrist movements. This rest allows the wrist and thumb tendons to heal. Another effective tip is to use ergonomic tools or adjust your hand positions, which can help prevent further irritation.
• Splinting (Brace or Thumb Spica Splint) – You doctor may advise you to wear a splint to stabilise the wrist and thumb, reducing strain on the affected tendons. A splint is often worn for 2 to 6 weeks to allow healing.
• Ice Therapy – Applying ice packs to the affected area for 10-15 minutes, several times a day can help reduce swelling and alleviate pain. Once the swelling has subsided, the tendons will have a better chance at healing.
• Stretching and Strengthening Exercises – Gentle exercises for De Quervain’s Tenosynovitis improve thumb and wrist mobility while preventing stiffness. These exercises should be done under the guidance of a physical therapist.
• Heat Therapy – Applying warm compresses before stretching can help relax muscles and improve tendon flexibility.
• Medications – If the condition is causing a lot of pain, the doctor may prescribe over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to help relieve pain and swelling.
• Corticosteroid Injections – The doctor may also recommend another effective treatment for De Quervain’s syndrome that involves administering a steroid injection into the tendon sheath. This injection can provide significant pain relief by reducing inflammation. This is often an effective treatment and can eliminate symptoms in 70-80% of cases.
• Physical Therapy – A therapist may recommend manual therapy techniques, tendon gliding exercises, and ultrasound therapy to reduce pain and improve function.
• Massage Therapy – You can also try massage therapy for de Quervain’s syndrome. Gentle massage can help break down scar tissue, reduce tension, and promote circulation to the affected area, promoting healing.

Surgical Treatment

If non-surgical treatments do not provide relief, your doctor may recommend surgery. Surgery for de Quervain’s disease is called de Quervain’s release surgery. The procedure involves opening the tendon sheath to relieve pressure, allowing the tendons to move freely. The surgery is often performed under local anaesthesia as an outpatient procedure. It has a minimal recovery time, with most patients resuming normal activities within 4 to 6 weeks.

Preventing De Quervain’s Tenosynovitis

Although any one can get De Quervain disease, there are certain strategies that one can follow to reduce the risk of getting it. Especially, if you have a job or engage in activities that require repetitive hand movements and lifting, it is important for you to follow these strategies to prevent the condition from developing. These include:

• Taking Breaks – Avoid prolonged repetitive wrist and thumb movements.
• Using Proper Ergonomics – Adjust workstations and tools to reduce wrist strain.
• Performing Strengthening Exercises – Perform thumb and wrist strengthening exercises to maintain flexibility.
• Avoiding Overuse – Try to alternate tasks to prevent excessive strain on the wrist tendons.
• Managing Underlying Conditions – If you have underlying conditions such as arthritis or hormonal imbalances, it is crucial to control them to help reduce inflammation in the body and consequently, prevent de Quervain’s syndrome.

When to See a Doctor For De Quervain’s Tenosynovitis

Although De Quervain’s Tenosynovitis does not pose any emergency, there are certain situations where you should consider seeking medical attention. These include:

• If your pain persists despite rest and home treatments.
• If the swelling worsens or affects your daily activities.
• If the thumb or wrist becomes increasingly stiff and painful.

Conclusion

De Quervain’s tenosynovitis is a common condition that affects many individuals. However, with effective conservative treatments and home remedies, it can be managed so that pain can be relieved and normal wrist movements are regained. If the condition is diagnosed early, conservative measures such as resting, wearing a splint, performing exercises, or administering corticosteroid injections can significantly improve symptoms. In severe cases, surgery provides an effective long-term solution. If you experience persistent wrist pain or difficulty with thumb movements, seek medical advice to prevent further complications. Contact Ray of Health today to start your journery towards effective pain relief.

Frequently Asked Questions

Can de Quervain’s tenosynovitis heal on its own?

Mild cases of de Quervain’s may improve with rest, splinting, and anti-inflammatory medications. However, persistent cases often require medical intervention.

How long does it take to recover from de Quervain’s?

The time it takes to recover from de Quervain’s syndrome varies depending on the type of treatment and other factors. With conservative treatment, improvement can be seen within a few weeks to months. Post-surgery recovery typically takes 2-6 weeks. Without any kind of treatment, the condition may recover but it can take months or a year for the pain to completely go away. 

How can I treat de Quervain’s tenosynovitis at home?

You can do several measures at home to treat de Quervain’s at home. These include applying ice, wearing a splint, avoiding repetitive movements, and performing gentle exercises to help alleviate symptoms.

Is de Quervain’s tenosynovitis a type of arthritis?

No it is npt, but it can be associated with inflammatory conditions like rheumatoid arthritis.

What are the best exercises for de Quervain’s syndrome?

Some of the most effective exercises for de Quervain’s tenosynovitis include:

• Thumb Stretch – Gently pull the thumb back and hold for 15-30 seconds and release.
• Wrist Flexion Stretch – Bend the wrist forward and hold for 10-15 seconds.
• Tendon Gliding Exercise – Move the thumb through its full range of motion to maintain flexibility.

Can de Quervain’s tenosynovitis recur?

Yes, this condition can recur, particularly if repetitive thumb and wrist activities continue. Proper ergonomics and preventive exercises can reduce the chance of recurrence.

Does de Quervain’s require surgery?

Although most cases of de Quervain’s improve with non-surgical treatments, surgery may be needed if symptoms persist.