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Treatments and drugs
By Mayo Clinic staffTreatment for de Quervain's tenosynovitis may include medications, physical or occupational therapy, or surgery. Treatment is generally successful if begun early on, though the pain may recur if you can't discontinue the repetitive motions that aggravate your condition. If you start treatment early on, your symptoms of de Quervain's tenosynovitis should generally improve within four to six weeks. When de Quervain's tenosynovitis starts during pregnancy, symptoms usually get better around the end of pregnancy or when breast-feeding stops.
Medications
To reduce pain and swelling, your doctor may recommend using NSAIDs, such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve).
Your doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.
Therapy
Initial treatment of de Quervain's tenosynovitis may include:
- Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
- Avoiding repetitive thumb movements whenever possible
- Avoiding pinching with your thumb when moving your wrist from side to side
- Applying ice to the affected area
You may also see a physical or occupational therapist. These therapists may review your habits and give suggestions on how to make necessary adjustments to relieve stress on your wrists. Your therapist can also teach you exercises focused on your wrist, hand and arm to strengthen your muscles, reduce pain, and limit the irritation of the tendons. The therapist may also make a splint to keep your wrist and thumb from moving if off-the-shelf versions don't fit you well.
Surgery
If your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure and restore free tendon gliding.
Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.
- De Quervain's tendinitis (De Quervain's tendinosis). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00007. Accessed June 13, 2012.
- South-Paul JE, et al. Current Diagnosis & Treatment in Family Medicine. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=52. Accessed June 13, 2012.
- Sheon RP, et al. de Quervain's tenosynovitis. http://www.uptodate.com/index. Accessed June 13, 2012.
- Bray J, et al. Evaluation of the patient with thumb pain. http://www.uptodate.com/index. Accessed June 13, 2012.
- Suttle AL, et al. Disc jockey tenosynovitis. The American Journal of Medicine. 2011; 124:e1.
- Peters-Veluthamaningal C, et al. Corticosteroid injection for de Quervain's tenosynovitis. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005616.pub2/abstract. June 13, 2012.
- Amadio PC (expert opinion). Mayo Clinic, Rochester, Minn. June 30, 2012.
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