DeQuervain's syndrome (patient information)

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What is DeQuervain's syndrome?

DeQuervain's Syndrome is an inflammatory condition in the wrist. It is commonly caused by cumulative injury. Patients with DeQuervain's syndrome may feel pain, tenderness and swelling around thumb, even loss of function. Finkelstein’s test is common used to diagnose DeQuervain's syndrome. Treatments include medications to relieve pain, physical therapy to improve muscle strength. Surgery needs to be considered if patients with DeQuervain's syndrome do not respond well to medications or physical therapy. Most patients can recover after treatments.

How do I know if I have DeQuervain's syndrome and what are the symptoms of DeQuervain's syndrome?

Patients with DeQuervain's syndrome may experience the following symptoms:

• Pain: Pain at the base of the thumb is the main symptom of DeQuervain's syndrome. The pain may be sudden or gradual, and may spread further into the thumb or the forearm.
• Tenderness and swelling around thumb.
• Loss of function in the thumb

Who is at risk for DeQuervain's syndrome?

The cause of DeQuervain's syndrome is the following:

• Overuse of the wrist, activities such as that involve frequent lifting, wringing or peeling. For example, new mother is at risk of developing DeQuervain's syndrome.
• Eccentrical load on the wrist, activities such as lowering a child or putting a heavy stack of plates down.
• Some occupations, such as office workers, musicians, carpenters.

How to know you have DeQuervain's syndrome?

• Medical history including location of pain, decreased or loss of function in the hand
• Finkelstein’s test: This test is common used to diagnose DeQuervain's syndrome. In this test, the patient makes a fist with the fingers over the thumb then bents the wrist towards the little finger. Pain on the thumb side of the wrist means a positive result and suggests the diagnosis of DeQuervain's syndrome.

When to seek urgent medical care?

Call your health care provider if symptoms of DeQuervain's syndrome develop.

Treatment options

The goal of treatment of DeQuervain's syndrome is to relieve pain.

• Rest, avoid to overuse or eccentrical load on the wrist.
• Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to control inflammation and pain in patients with DeQuervain's syndrome. Usual drugs include ibuprofen, naproxen and indomethacin. Usual side effects are pain, bleeding and ulcers in upper gastrointestinal tract.
• Corticosteroids: Corticosteroids are generally prescribed for patients who cannot take NSAIDs or have no good fesponse to NSAIDs. These drugs can be used by oral or by injection into the area to control inflammation and pain. Side effects of corticosteroids may include a decreased ability against infection and worse healing in the wound.

• Physical therapy: It is an effective treatment for DeQuervain’s syndrome, including using heat/ice, ultrasound to mobilize the tendons and joints. Moreover, the therapist may do some progressive resistive exercises to help you recover.
• Surgery: If the above treatments fail, surgery needs to be considered. Surgery can release the tendons and provide more space for them to move.

Diseases with similar symptoms

• Ganglion cyst

Where to find medical care for DeQuervain's syndrome?

Directions to Hospitals Treating DeQuervain's syndrome

Prevention of DeQuervain's syndrome

• Avoid to overuse or eccentrical load on the wrist.
• Stretching may help you improve muscle flexibility.

What to expect (Outlook/Prognosis)?

Prognosis of DeQuervain's syndrome is good. Many patients can recover after rest or physical therapy, few people with DeQuervain's syndrome need surgery.

Copyleft Sources

http://www.thestretchinghandbook.com/archives/quervains-syndrome.php

http://www.aidmytendon.com/writeups/de-Quervains-syndrome.php

http://www.rehabmed.net/patient_ed/dequervains_syndrome1.html

http://mcr.coreconcepts.com.sg/dequervains-syndrome/