What is de Quervain’s disease?

De Quervain’s disease causes pain when you move your wrist and thumb, and usually a tender swelling at the base of your thumb.

The two tendons that move your thumb usually glide freely through a tight tunnel (sheath) at the base of your thumb. If the fibrous roof of the tunnel thickens, the tunnel becomes too tight, usually resulting in pain when you move your wrist and thumb (see figure 1). Sometimes your wrist and thumb may feel stiff and your thumb may lock slightly when you move it.

What are the benefits of surgery?

The aim is to relieve the pain at the base of your thumb.

Are there any alternatives to surgery?

If your symptoms are mild, resting your wrist and thumb, wearing a splint at night, physiotherapy and anti-inflammatory medication may ease the pain.

A steroid injection into the base of your thumb can treat the problem in up to 8 in 10 people.

What does the operation involve?

The operation can usually be performed under local anaesthetic and usually takes about 30 minutes.

Your surgeon will make a small cut at the base of the thumb. They will cut open the fibrous roof of the tunnel. This allows the tendons to glide freely.

What complications can happen?

1 General complications of any operation

  • Pain
  • Bleeding
  • Scarring
  • Infection of the surgical site (wound)

2 Specific complications of this operation

  • Numbness at the back of your thumb
  • Tenderness of the scar
  • Thumb tendons moving out of place
  • Severe pain, stiffness and loss of use of your hand (complex regional pain syndrome)

How soon will I recover?

You should be able to go home the same day.

Keep your hand raised and bandaged for two days. It is important to gently exercise your fingers, elbow and shoulder to prevent stiffness.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

For 8 in 10 people, symptoms improve quickly, but your wrist and thumb may ache for a number of weeks.

Summary

De Quervain’s disease causes pain when you move your wrist and thumb, and usually a tender swelling at the base of your thumb. If treatment with steroid injections has failed, surgery should relieve your pain.

Acknowledgements

Author: Prof Tim Davis ChM FRCS (Tr. & Orth.)

Illustrations: Medical Illustration Copyright © Nucleus Medical Art. All rights reserved. www.nucleusinc.com


This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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