Hawaii Oriental Medicine 
and Acupuncture Association
 

Painful Wrist and De Quervain’s Tendonitis

De Quervain’s Tendonitis

De Quervain’s Tendonitis is a condition brought by irritation or swelling of the tendons found along the thumb side of the wrist.

The irritation causes the lining around the tendon to swell, changing the shape of the compartment; this makes it difficult for the tendons to move. 

The swelling can cause pain and tenderness along the thumb side of the wrist, usually noticed when forming a fist, grasping or griping things or turning the affected wrist.

Signs and Symptoms:                                      

Pain over the affected thumb side of the wrist is the main symptom.    

The pain may appear either gradually or suddenly.  It is felt in the wrist and can travel up the forearm.

The pain is usually worse with use of the hand and thumb, especially when forcefully grasping things upward or twisting the wrist.

Swelling over the thumb side of the wrist is noticed and may be accompanied by a fluid-filled cyst in this region.

There may be an occasional “catching” when moving the thumb.

Because of the pain and swelling, it may be difficult to move the thumb and wrist, such as in pinching.

Irritation of the nerve lying on top of the tendon sheath may cause numbness on the back of the thumb and index finger.

Diagnosis:

A Finkelstein test is usually performed. In this test, the patient makes a fist with the fingers over the thumb.

The wrist is then bent in the direction of the little finger.

This test can be painful for the person with de Quervain’s tendonitis.

 Treatment:

The goal is to relieve the pain caused by the irritation and swelling.

In some cases, your doctor may recommend resting the thumb and wrist by wearing a splint.

Acupuncture may improve blood circulation which supplies more oxygen and nutrients to the surrounding tissues by vasomotor effects and helps subside inflammation and tenderness to enhance the healing process.

When symptoms are severe or become advanced, surgery may be recommended. The surgery opens the nerve covering to make more room for the irritated tendons. Normal use of the hand can usually be resumed once comfort and strength have returned.

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