De Quervain's Disease (Thumb base pain)

Many a times there is unbearable pain at the base of the thumb and near wrist without any injury. This could be what is known as De Quervain's Tenosynovitis.

Lets understand whats DQ's disease from Expert Orthopedic surgeon Dr. Pranav Patel.

DQ's Ds is a problem with tendons of thumb side of your wrist. Tendons are round string like structures which attach to muscles to bones. They are covered with a sheath near narrow areas which allows smooth gliding of the tendons. Whenever there is inflammation of the sheath, there is difficulty in movement of the tendons and thus movements become painful.

Movement of the thumb is the responsibility of many muscles, of which the tendons of two muscles abductor policis longus and extensor policis brevis travel together in a tunnel near wrist at the base of thumb. Any inflammation (swelling) of these tendon sheath (cover) causes reduced gliding movement between each other and thus painful thumb movements.

Its is more common in the non dominant hand. i.e. it affects left side in right handed person.

Causes of DQ's Ds

Overuse of thumb or wrist.

Most commonly due to long time use of phones.

There is swelling and pain. Pain may go upto the mid part of forearm or upto the elbow above and upto the thumb below. Sometimes there can be cracking sound felt on touching.

How to confirm that your thumb pain is DQ's Ds or not.

Make a fist with thumb inside as shown in the picture.

Then move the wrist towards little finger.

If there is excessive pain its DQ's Ds.

Treatment:

1) Stretches: (exercises)

touching fingers with thumb

press pinky finger with thumb

wrist flex/ext

can up/down

rubber band stretches

Local Heat.

apply hot packs to the part of wrist where there is maximum pain. 

2) Reduction of work from same hand.

3) Medications (as prescribed by your doctor).

4) Injections near the sheath.

Injection near the sheath by your doctor can be beneficial and can reduce the pain and also help in reducing the inflammation. 

5) Surgery:

It is a small surgery done under local anesthesia. The band which presses over the tendon sheaths is cut and released. Procedure takes hardly 15-20 mins.  There may be 2-3 stitches. No need to take rest and patient can resume duty from the very next day. It is permanent solution for the problem. 

Dr Pranav Patel 
M.S. Ortho
Fellow in Arthroscopy and Sports Medicine 
Fellow in Sports Rehabilitation

Sankalp hospital, vasna road, 
Near Kalyan party plot,  Vadodara, Gujarat, India 

+91 96648 86737

This blog is for information purposes only, kindly consult your Doctor before starting any treatment.