De Quervain’s Tenosynovitis: Overuse Related Thumb Pain

De Quervain’s Tenosynovitis Is A Common Cause Of Thumb Pain

De Quervain’s tenosynovitis is a condition causing pain around the wrist at the base of the thumb. Discomfort is often experienced when the individual uses their thumb in a hitch hiking type posture and when performing actions where the wrist and thumb are pointing down towards the ground. Pain may extend from the wrist down towards the thumb, and likewise up away from the wrist into the lower forearm. The cause of the pain associated with de Quervain’s tenosynovitis is typically related to inflammation at least in the onset and acute phase. The inflammation involves the synovium, which is the inner lining of the sheath that surrounds many tendons as they travel across moving parts. This sheath protects, lubricates and provides nutrition to the tendon it is associated with. In this condition inflammation of the synovium of the sheath is in reaction to over use of the tendons that help move your thumb.

Signs And Symptoms

Individuals with De Quervain’s tenosynovitis will most likely experience discomfort and ultimately limitation associated with grasping objects, making a fist, performing pinching movements and even actions requiring turning at the wrist.
People suffering this condition may also notice:

• Visible swelling near the base of your thumb, sometimes this can be quite significant and somewhat alarming to people.
• Palpable creaking sensations associated with movement of the tendons, this creaking may be palpated at, and above the wrist.
• A “sticking”, “catching”, “grabbing” type sensation of the thumb when moving it.

If not addressed and pain is allowed persist then as mentioned pain may spread further down towards the thumb and/or further up into your forearm.

De Quervain’s Tenosynovitis And Motherhood

Chronic overuse of your thumb and wrist is the most common cause of De Quervain’s tenosynovitis. Your tendons are rope-like structures that attach your muscle to bone and transmit the forces of any muscle action on the body. When gripping, grasping, clenching, pinching, or wringing actions are performed in a repeated sense this may overload the tendon and the protective sheath causing thickening and swelling of this tendon sheath complex causing pain.

This cause of thumb pain is common in pregnancy and new mothers. Constant lifting, patting, carrying… associated with being a new parent can cause a sudden overload to the tendon-sheath complex as new parents go from zero to 100 over night and there is little time for tissues to adapt to their new roles. Accompanied with reduced sleep, rest, self care and hormonal changes it is not surprising that new mums are quite prone to developing tenosynovitis type thumb pain.

Who Else Experiences De Quervain’s Related Thumb Pain?

De Quervain’s Tenosynovitis is not an issue exclusive to new mothers. In the general population it is an overuse injury and is seldom caused as the result of an accident, or specific incident, but as mentioned due to an over load on the thumb. Similar to most tendon complaints it is most commonly seen in people aged 30-50 years old an age where as a rule tendons are less tolerant of loading changes and more reactive.

Other suggested causes of De Quervain’s tenosynovitis include:
• A direct injury/impact to the wrist or tendon. Although uncommon, a trauma such as this may create a local inflammatory situation with the tendon and tendon sheath resulting from the direct impact, or cause scar tissue post trauma, restricting freedom of movement of the tendons potentially creating a vulnerability to irritation further down the track.
• Inflammatory arthritis, such as rheumatoid arthritis. Individuals with rheumatoid arthritis have an increased presentation of De Quervain’s thumb pain.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding De Quervain’s Tenosynovitis: Overuse Thumb Pain should consult his or her general practitioner or physiotherapist or suitably skilled practitioner.