CHECK-UP:Often caused by doing new activities, de Quervain's syndrome can lead to tendon swelling, writes MARION KERR.
ABOUT A week ago I got a sudden pain in my left wrist which hasn’t gone away. I looked up my symptoms on the internet and think I have de Quervain’s syndrome.
De Quervain’s syndrome is inflammation and swelling of the tendons (or tendon sheaths) that move the thumb outwards. The condition is brought on by irritation or inflammation of the wrist tendons at the base of the thumb.
The inflammation causes the compartment which houses the tendon to swell and enlarge. Movements such as making a fist or gripping tend to cause pain over the thumb side of the wrist, that may radiate down the thumb and up the forearm.
A swelling may develop over the base of the thumb and, occasionally, a small fluid-filled cyst may form. Some sufferers feel a snapping or catching sensation on moving the thumb. They may also have numbness on the back of the thumb and index finger caused by irritation of the nerve lying on top of the tendon sheath.
I believe unfamiliar activities can bring it on. The only unusual activity I’ve been doing is hand washing clothes while on holiday. Could this have brought it on?
Although the condition is named after a Swiss surgeon, Fritz de Quervain, it is sometimes called washerwoman’s sprain. It is usually caused by doing an unfamiliar, repetitive activity, most probably, in your case, wringing out clothes.
It can also develop following a fracture of the wrist or can occur in new mothers – thought to be brought on by a combination of fluctuating hormonal levels and unaccustomed hand movements associated with caring for a baby.
Will an X-ray confirm the diagnosis?
Diagnosis can usually be done by your doctor using a test known as the Finkelstein manoeuvre.
This is done by tucking the affected thumb into the palm and wrapping the fingers over the thumb.
A diagnosis of de Quervain’s is made if pain is felt when the wrist is bent in the direction of the little finger.
Treatment is aimed at reducing irritation and swelling. It is important to identify and stop the actions that are causing the problem and rest the affected tendons by wearing a thumb and wrist splint.
While oral anti-inflammatory medication should help to address the problem, in more severe cases steroids may need to be injected into the tendon compartment.
Where symptoms do not resolve with conservative treatment, surgery to enlarge the compartment may be required.