DeQuervain’s Tendinitis

DeQuervain’s tendinitis leads to pain on the radial (thumb’s side of the) wrist. It’s usually worse with lifting and gripping. DeQuervain’s tendinitis is due to a space problem, that is too much stuff in too little space. The tendons of your wrist travel through tunnels. When you overuse them, swelling enters the tunnels, pinching the tendon. Pregnancy can also cause fluid to enter the tunnel, leading to pain. Sometimes, diabetes, thyroid disorders or simply aging can cause the tunnel to become too tight.

Treatment starts with nonoperative measures. Avoid lifting with the thumb up, such as lifting small children under the armpit or pulling weeds. Lifting this way really stresses the tendon; lifting with the palm up or the palm down causes less pain. A splint may be helpful. An injection decreases any swelling or inflammation in the tunnel, often providing signficant pain relief. Unfortunately, sometimes there’s a very small subsheath (a second tunnel) that causes problems; this can be difficult to improve with injections.

If nonoperative treatments don’t work, or if they work but the tendinitis recurs, a surgical release is very effective. This allows the tendon to heal. How long it takes to feel better is often dependent on how damaged the tendon was by the tunnel’s constriction. Simply releasing the tunnel may allow the tendons to sublux (move up and down) after surgery, which can be uncomfortable and annoying. To prevent this, I reconstruct the tunnel around the tendons in a lengthened fashion, like a seatbelt, to prevent the tendons from moving. This is outpatient surgery usually performed under local anesthesia.

Please keep the wound clean and dry for one week. Bathing is safer than showering. Wrap a towel around the dressing in case any water gets in, then place a plastic bag over your hand and secure it tightly with rubber bands. A splint is used for one week after surgery. After 5 days you can remove your dressings and the splint and get your incision wet in the shower. Blot it dry. There are no stitches to remove (they’re buried and absorbable). There are little pieces of tape over your wound. The longer they stay, the nicer the final wound may look. They’ll fall off when they’re ready. Please don’t submerge your incision under water (like swimming, or putting your hand under water while doing dishes) for 10 days after surgery.

Try to avoid heavy lifting and gripping while the tendon is trying to heal. Otherwise, computer use and typing are fine immediately after surgery.