DeQuervain's Tenosynovitis (Thumb-sided wrist pain)

A common but easily treated problem. If surgery is needed, it's a 5-minute procedure, local anesthesia, and works great!

What is it?
This is a condition where a group of tendons that normally move the wrist and thumb become painful because of friction in the lining of the tendons. The first symptom of this is usually pain in the wrist at the base of the thumb, which is worse with use of the thumb and bending of the wrist. It can cause swelling or even a knot on the wrist which can be quite tender.

What causes it?
It is caused by inflammation (often from long-term overuse) of the lining around the tendon, and even of the tendon itself. This inflammation results in an enlarged tendon and tendon lining, and this is what causes the increased friction and pain.

Will it get worse?
It is possible for it to just go away, but if there is swelling or a knot, it is not likely to heal on its own. It will often progress and impair function of the whole hand because of pain and a feeling of weakness.

What is the treatment?
Bracing and therapy are quite effective for this condition. Medicines like aspirin, Tylenol, Motrin and other anti-inflammatories may help with the symptoms. An injection given in the tendon lining by your doctor can often resolve this problem. Sometimes 2 or even 3 injections might be necessary. Surgery is very effective for this condition.

Do I need surgery?
Most patients do not need surgery for this, as most respond well to medicines and injections.

Tell me about the surgery
If injections and medicines don't work, surgery may be recommended. It is an outpatient surgery, meaning you go home the same day as surgery. It is done with local anesthesia, meaning you don't have to go to sleep. Patients don't feel anything and are very comfortable due to the sedative drugs given. It takes about 15 minutes, and is done through a very short (less than 1 inch) incision which is often invisible after it is healed.

Is surgery safe?
Your surgeon will discuss the risks with you, but it is a very safe and effective procedure.

How long would I be out of my job after surgery?
You will be sent home with a splint (brace) on your hand and wrist. You should move your fingers the day of surgery, as this helps prevent and reduce swelling and stiffness. The stitches are absorbable and don't have to be removed. Jobs with clerical or light-type of work can be resumed within a week, heavier duty-type jobs such as manual labor can be done after 2-4 weeks in most cases. Many people have returned to their jobs the day after surgery - it really depends on the job type more than anything.