What is it?

DeQuervains Tenosynovitis is a painful wrist disorder that is thought to be due to thickening (Stenosing) of the tendons responsible for movement of the thumb. As the tendons thicken, they are thought to become inflamed, resulting in the pain associated with DeQuervains. The most commonly affected athletes are racquet and rowing sports, along with volleyball. Women are more commonly affected than men, with increased risk in the postpartum period of pregnancy.

Sports Medicine Evaluation & Treatment

Upon evaluation by a Sports medicine physician, the affected thumb tendons will be stretched by making a fist grasping the thumb and flexing downward toward the pinky finger (Finkelstein’s Test). DeQuervains Tenosynovitis is likely if this maneuver causes pain. Imaging and further tests are often not needed. Once DeQuervains is diagnosed, conservative treatment such as immobilization and anti-inflammatory medications can be used. A course of physical therapy may be considered as well. If these fail to improve the pain after 4-6 weeks, a steroid injection may be considered. Although, this can happen sooner in some cases.

Procedure Details and Post-Procedure Guidance

The painful tendons will be identified for injection, the surrounding skin cleaned and a small amount of steroid mixed with numbing medication will be injected around the tendon. Over the next 12-24 hours, the steroid will take effect and pain should diminish. Complications are rare, but can include infection, discoloration (hypopigmentation) of the skin, bleeding or allergic reaction to the medicine. Following injection, the patient should avoid activity that stresses the tendons for at least 48 hours. Range of motion and strengthening can then take place.

Return to Play

Returning to sports and other activities depends on the extent of symptoms and range of motion the athlete has regained after treatment. Return to play can occur once range of motion and strength have returned.

AMSSM Member Authors
Thomas Stocklin-Enright, DO and Alyssa Horne, DO

References
1) Tallia AF, Cardone, DA. Diagnostic and Therapeutic Injection of the wrist and Hand Region. Am Fam Physician. 2003 Feb 15;67(4):745-750.
2) DeLee JC, Drez DJ, Miller MD, Thompson SR. DeLee & Drez’s Orthopedic Sports Medicine: Principles and Practices, 4th Edition. Elsevier Inc; Published January 1st, 2015: 75, 868-874. e1.