What is a DeQuervain (day-kwer-vain) tendinopathy?

DeQuervain tendinopathy involves the tendons that run along the thumb side of the wrist.  Tendons anchor muscle to bone, and the tendons associated with this condition help to pull the thumb out and away from the palm.  These tendons travel under a ‘’tunnel’’ located on the thumb side of the wrist.  People will notice pain in this area with wrist and thumb movements when the tendons move back and forth under the tunnel.

What are the symptoms?

Pain will be noted along the thumb side of the wrist and can radiate down the thumb or up the forearm.  Pain may be present when reaching across the palm with the thumb when pinching or with movements of the wrist.  A twisting motion, such as wringing out a washcloth, can also create pain.

What causes DeQuervain tendinopathy?

It is thought to be from thickening and narrowing of the first compartment, where the tunnel is located.  This may occur because of inflammation or degeneration of the tendons of the first compartment.  It then restricts the thumb tendons from gliding freely and smoothly through the tunnel, which is creating pain.  It can be associated with overuse or may develop for no apparent reason.  It can also develop in new mothers, thought to be caused by swelling and hormonal changes that occur with pregnancy.

What is the treatment of DeQuervain tendinopathy?

Treatment can be surgical or conservative (non-operative).  Your physician may recommend anti-inflammatory medications or steroid injection into the painful area.  Your physician may also refer you to a hand therapist for an evaluation.  Surgery may be recommended for severe symptoms lasting 6 months or longer.  Most patients do not need surgery and can be successfully treated conservatively.

What can a hand therapist do for me?

The hand therapist works directly with the doctor to best address the injury.  The therapist will help the patient determine which activities aggravate the symptoms and can also help with activity modification.  A custom orthosis for the wrist and thumb may be made to provide rest for the injured tissues.  If surgery is necessary, hand therapy following surgery is important to restore range of motion and return to previous meaningful activities.

If you have any questions about DeQuervain tendinopathy or hand therapy, please contact the Rehabilitation Services at North Country Hospital, 802-334-3260.

References: www.asht.org/patients/patient-education-resources

Submitted by Johanne Champigny, OTR/L, CHT.  Johanne was the first occupational therapist at NCH when she joined the Rehab team in 1995.  She became certified as a hand therapist in 2015.  She works primarily with outpatients and is also the OT department supervisor.