How is De Quervain’s Tenosynovitis Diagnosed?
DiagnosisDe Quervain's tenosynovitis can often be diagnosed during a physical exam. Your doctor will check your hand and wrist for swelling and see if you feel pain when pressure is placed on the thumb side of the wrist.
Your physician may also perform the Finkelstein test, in which you’ll make a fist with your thumb under your fingers and bend your wrist toward your pinky finger. If you feel pain along the thumb side of your wrist, you may have de Quervain's tenosynovitis. Imaging exams such as X-rays are not usually needed.
How is De Quervain’s Tenosynovitis Treated?
TreatmentsYour doctor will most likely recommend nonsurgical de Quervain's tenosynovitis treatments first. Surgery is not typically used unless nonsurgical methods aren’t helping to relieve your symptoms.
Nonsurgical treatments
About 50%-80% of people with de Quervain's tenosynovitis respond well to nonsurgical treatments and do not need surgery. You may have one or more of these therapies:
- Medication to reduce inflammation and relieve pain, such as ibuprofen or naproxen
- A splint to keep your wrist in a comfortable position. You may need to wear it 24 hours a day for as long as 4-6 weeks.
- Applying a cold pack to your wrist to reduce swelling
- Avoiding the activities that are causing your discomfort
- One or two injections of a corticosteroid, such as cortisone, into the tendon sheath to reduce inflammation
- De Quervain's tenosynovitis massage to help relieve swelling and discomfort
- Exercises to strengthen muscles and reduce pain and tendon irritation. An occupational or physical therapist can assess your movements and instruct you about better ways to move your wrist.
De Quervain's tenosynovitis surgery
If your pain and swelling persist despite nonsurgical therapies for de Quervain's tenosynovitis, your doctor may recommend surgery. You’ll be given a local anesthetic and a sedative so you are comfortable during the procedure. The surgeon makes a small incision in your wrist, locates the tendon sheath, and makes a small cut in the sheath to release the pressure on the underlying tendons.
You'll wear a splint after the surgery. As you recover, you will need to do exercises to promote strength and flexibility in your wrist. This surgery is very effective for eliminating swelling and pain and restoring the range of motion to your wrist and thumb.
Trust NewYork-Presbyterian for De Quervain’s Tenosynovitis Care
The hand and wrist contain many delicate structures and require the expertise of experienced orthopedic specialists to understand and treat disorders such as de Quervain's tenosynovitis. You can find those professionals at NewYork-Presbyterian Columbia Orthopedics. Our Hand and Upper Extremity Service was first established in 1949. Now, decades later, our surgeons treat some 5,000 patients on an outpatient basis each year and perform 1,000 operations annually. Make an appointment with one of our orthopedic experts and learn how you can start feeling better.