De Quervain’s tenosynovitis is a common cause of pain and discomfort in the wrist and thumb. It often arises from repetitive use or overuse of the muscles and tendons. The tendons connect the muscles to the bone for movement. The tendons that help the thumb with grip run through a tunnel. With overuse, the tendons and surrounding structures become inflamed and painful. Fortunately, de Quervain’s tenosynovitis treatment starts at home with a few key tips.

Diagnosis

De Quervain’s presents with pain and tenderness at the thumb side of the wrist. Holding or gripping objects increases discomfort. Additionally, pain in the area is increased when the tendons are stretched. The tendons are stretched by making a fist around the thumb then moving the wrist in the direction that stretches the tendons as shown below.

Often times, different conditions can present in a similar manner. In this case, arthritis at the base of the thumb can present similarly. Arthritis causes tenderness and sometimes swelling right at the thumb joint. Joint motion aggravates thumb pain. Luckily, the initial treatment for both conditions is similar and starts at home.

Treatment–At Home Care

Fortunately, there are many things to try at home to treat de Quervain’s tenosynovitis. Like other repetitive use injuries, activity modification is key. Activity modification means reducing the movements that irritate the area. For example, a common activity modification is reducing an irritating activity by 50-75%. Such that if 3 hours of gardening per day worsens symptoms, then gardening is reduced to 1 hour per day. Activity modification allows the area to rest and heal. Another way to rest the area is to use a brace. A brace rests the area by providing relative immobilization.  For de Quervain’s, a forearm-based thumb spica splint works best.

In addition to activity modification, anti-inflammatory measures help reduce pain. A great anti-inflammatory for the thumb area is ICE since the tendons are superficial. Ideally, ice the painful area for 15 minutes two to three times a day. If ice doesn’t provide adequate relief, anti-inflammatory medications are an option. Commonly used medications include ibuprofen (shorter-acting) or naproxen (longer-acting). This area may also respond to topical medications such as Voltaren gel. All are available over-the-counter. Exercises to stretch and strengthen the muscles that support the thumb may be useful as well.

If symptoms are not improving with the above measures there are more interventions available through a medical provider. For instance, steroid injections can be helpful for severe symptoms. They provide a strong and local reduction in inflammation. As a last resort, surgical interventions are also available.

Summary

Thumb tendonitis is a common cause of pain and discomfort of the wrist and thumb. de Quervain’s tendonitis is a type of tendonitis involving wrist and thumb tendonitis used when gripping objects. The mainstays for home care include activity modification, bracing, and anti-inflammatory measures. Additionally, exercises to stretch and strengthen the muscles that support the thumb may be useful. If symptoms do not improve with the above measures, there are more invasive interventions available through a medical provider.