What is De Quervain's Disease? Causes, Symptoms, Diagnosis & Treatment

Medically Reviewed by Dr Sravya, MBBS, MS

Why is De Quervain's disease named De Quervain's disease?

De Quervain disease is also known as De Quervain’s tendinitis. It is named after Fritz de Quervain (a Swiss surgeon), who first described the condition.

What is De Quervain's disease?

De Quervain disease is painful and affects the tendons on the thumb and wrist. It primarily causes inflammation of the tendons that control the movement of the thumb. And inflammation can lead to pain, swelling, and difficulty moving the thumb and wrist.

 The typical reason for De Quervain disease is repetitive hand and wrist movements or overuse, such as continuous grasping, lifting, or repetitive thumb motions like texting. Moreover, it is more common in women than men and often affects individuals between 30 and 50.

De Quervain’s disease

How to Identify De Quervain Syndrome Symptoms

These are the common symptoms of De Quervain disease:

De Quervain Disease Causes: What Are They?

De Quervain’s disease is primarily caused by irritation or inflammation of the tendons that control the movement of the thumb. The exact cause of the inflammation is not always clear, but several factors can contribute to the development of De Quervain’s tenosynovitis,

1. Overuse of thumb and wrist

Overuse of the tendons in the wrist and lower thumb can cause De Quervain’s disease because it can cause inflammation of the tendons. This inflammation can cause swelling and pain in the wrist and lower thumb, as well as difficulty moving the thumb and wrist. Engage in repetitive motions or gripping and twisting activities, such as playing sports or using a computer mouse for extended periods. You may be at risk of developing De Quervain’s disease.

2. Pregnancy and breastfeeding

Pregnancy and breastfeeding can cause De Quervain disease because of the hormonal changes that arise during these times. These hormonal changes can lead to inflammation of the wrist and lower thumb tendons, which can cause pain and swelling. Additionally, the repeated lifting and carrying of a baby can also contribute to overuse of the wrist and lower thumb tendons, which can increase the risk of developing De Quervain’s disease.

3. Direct injury

A direct injury to the wrist or thumb area can cause inflammation and irritation of the tendons, leading to De Quervain’s disease.

4.Rheumatoid arthritis

As an autoimmune condition, rheumatoid arthritis can result in De Quervain’s disease. And it can cause joint inflammation. This inflammation can affect the wrist and lower thumb tendons, leading to pain and swelling. 

5. Age and gender

De Quervain’s is more common in women between 30 and 50 years of age.

 Although it’s important to note that individual factors, such as genetics and lifestyle, may also contribute to the development of De Quervain’s, avoiding excessive repetitive movements and taking breaks during activities that strain the wrist and thumb can help reduce the risk of this condition.

De Quervain Disease Diagnosis

De Quervain’s disease diagnosis involves a combination of a thorough medical history, a physical examination, and sometimes imaging tests. If you suspect you have De Quervain’s or are experiencing symptoms, it’s essential to consult a healthcare professional for an accurate diagnosis. Here’s how De Quervain’s disease is usually diagnosed:

Medical History

Your doctor may ask about your symptoms, their onset, and any activities or factors contributing to the wrist or thumb pain. They will also inquire about your occupation, hobbies, and any recent injuries or medical conditions that could be relevant.

Imaging Tests

In most cases, imaging tests like X-rays or ultrasounds are unnecessary for diagnosing De Quervain’s disease. However, they may be ordered if your doctor wants to rule out other conditions that can cause similar symptoms.

Physical Examination

During the physical examination, your doctor can assess the affected hand, wrist, and thumb. They will look for signs of swelling, tenderness, warmth, and redness in the area. They may also check your range of motion in the thumb and wrist and perform specific tests to evaluate the pain and irritation of the tendons.

Finkelstein Test

This test is used to diagnose De Quervain’s disease. During this test, the doctor can ask you to make a fist with your thumb tucked inside your fingers. Then, they will bend your wrist towards your little finger. If it causes pain on the thumb side of your wrist, you likely have De Quervain’s disease. The Finkelstein test is a simple and non-invasive way to diagnose De Quervain’s disease.

What are the De Quervain Syndrome Treatments?

The treatment for De Quervain disease aims to reduce inflammation, alleviate pain, and improve the function of the thumb and wrist. The treatment depends on the severity of the condition and may involve conservative (non-surgical) and, in some cases, surgical options. Here are the standard treatments for De Quervain’s:

1. Rest and Activity Modification

Avoiding activities that worsen the symptoms and giving the affected hand and wrist sufficient rest can help reduce irritation and inflammation of the tendons. If the condition is related to a specific repetitive activity, modifying or limiting that activity may be necessary.

2. Splinting

Wearing a thumb splint or brace can immobilize the thumb and wrist, allowing the inflamed tendons to rest and heal. The sling is usually worn continuously or during activities that may strain the wrist and thumb.

3.Ice Therapy

Applying ice packs to the affected area for about 15–20 minutes several times daily can help reduce swelling and relieve pain. Using a cloth or towel to wrap the ice pack is essential to prevent direct skin contact.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter medications like naproxen or ibuprofen can assist in reducing inflammation and pain. However, you must always consult a doctor before using any medicine.

5. Corticosteroid Injections

Some painkillers, like acetaminophen or ibuprofen, can help reduce pain and inflammation. Moreover, prescription medications may also be used in some cases.If symptoms are severe or are not improving with conservative treatments, your doctor may suggest corticosteroid injections. These medications work as anti-inflammatories and are injected directly into the affected area to reduce inflammation and provide relief. However, corticosteroid injections are not suitable for everyone and are typically limited to one or two injections due to potential side effects.

6. Physical therapy

A physical therapist might help with specific exercises to improve the flexibility and strength of the thumb and wrist. They may also employ techniques such as ultrasound or manual therapy to aid in the recovery process.

7. Occupational Therapy

Occupational therapists can guide adaptations to daily activities to minimize stress on the wrist and thumb and recommend ergonomic practices.

8. Extracorporeal Shock Wave Therapy (ESWT)

ESWT is a non-invasive procedure that uses shock waves to promote healing in the affected area. It may be considered for chronic or stubborn cases of De Quervain’s.

9. Surgery Intervention

Surgery may be recommended if conservative treatments do not provide relief or if the condition is severe. The surgical procedure involves releasing the constricted tendons to alleviate pressure and reduce inflammation. It is usually done outpatient, and the recovery time is generally quick.

 The treatment choice will depend on the individual’s condition and response to various therapies. However, it’s essential to consult with a doctor to determine the most suitable treatment plan for your specific case of De Quervain disease. Early intervention and appropriate management can significantly improve and relieve symptoms.