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Treatments and drugs
By Mayo Clinic staffTo reduce pain and swelling, 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
- Using NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve)
Your doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling.
Treatment is generally successful if begun early on, though the pain may recur if you continue the repetitive motions that aggravate your condition.
Making adjustments
Your medical care may include a visit with a physical therapist or occupational therapist, who 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 immobilize your wrist and thumb if off-the-shelf versions don't fit you well.
In more serious cases
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.
- De Quervain's tendinitis (De Quervain's tendinosis). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00007. Accessed Feb. 18, 2010.
- Sheon RP, et al. de Quervain's tenosynovitis.http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2010.
- Brady M. de Quervain's tenosynovitis. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/183172249-3/951902956/2088/183.html#4-u1.0-B978-0-323-05609-0..00013-7--sc0045_3682. Accessed Feb. 18, 2010.
- Ingari JV. Wrist and hand. In. DeLee JC, et al. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/183172249-3/951902956/2079/38.html#4-u1.0-B978-1-4160-3143-7..00020-8--s0350_2856. Accessed Feb. 18, 2010.
- Wright PE. Stenosing tenosynovitis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/183172249-5/951919611/1584/566.html#4-u1.0-B978-0-323-03329-9..50076-3--cesec17_4013. Accessed Feb. 18, 2010.
- Anderson BC. Evaluation of the patient with thumb pain. http://www.uptodate.com/home/index.html. Accessed Feb. 18, 2010.
- Amadio PC (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 23, 2010.
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