What is it about ?
Tendons attach muscles to bones, ensuring the transmission of movement. Some of these tendons are wrapped in a sheath in which there is a kind of lubricant which facilitates the movement of the tendon in this sheath. The tendon moves there in the same way as an arm in a sleeve.
Under normal conditions, the tendon easily slides through this sheath during movement. But when the membrane (connective tissue) around the tendon becomes inflamed, movements of the tendon in the sheath become more difficult.
There are two muscle tendons in the thumb, both of which are located in the same sheath. In De Quervain’s disease, the tendons and sheath of the thumb are inflamed, this is called tenosynovitis.
Tendinopathy does not develop without a reason. The most common cause is overexertion, usually due to repeating identical movements (for example grabbing an object or wringing a cloth). Tendinopathies are also sometimes associated with rheumatism.
In whom and how often does it occur?
We do not know the exact figures. Wrist tendinopathies are seen much more often in women than in men.
How to recognize them?
The main complaint with tendinopathies is usually pain in the inflamed tendon. They can also be accompanied by swelling of the tendon. The pain increases with exertion. Sometimes complaints are greatest in the morning and improve as the day progresses. When grasping an object, the hand may appear weak.
In De Quervain’s disease, the pain is usually just below the thumb. It hurts to move your thumb. Sometimes the tendons are swollen and make a crackling, squeaking sound.
How is the diagnosis made?
The doctor will suspect the diagnosis based on your story. This associated with the clinical examination of the wrist or thumb is generally sufficient to make the diagnosis. If in doubt, he will order an ultrasound and / or an x-ray.
What can you do ?
Tenosynovitis is often due to overwork, so it is important to put less strain on the tendon. The cornerstone of treatment is therefore to let your wrist rest.
Put ice on the wrist and on painful or swollen areas for about 15 minutes every 6 hours. Sometimes it is helpful to use a splint to support the wrist or thumb.
What can your doctor do?
If rest, ice, and / or a splint are not enough for improvement, the doctor may prescribe an anti-inflammatory drug or physical therapy to remove adhesions between the tendon and the sheath as well as to stretch the inflamed tendon. .
In some cases, it is possible to consider injections into the tendon with a cortisone solution. If the symptoms have not gone away 2 to 3 weeks after the first injection, a second injection may be necessary.
If these treatments remain insufficient, it will sometimes be necessary to proceed to a surgical intervention.
Want to know more?
- Radiography, here, Where to find on this page of Cliniques St Luc UCL
- Ultrasound here Where to find on this page of Cliniques St Luc UCL