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HealthInfo Canterbury

Living with de Quervain's tenosynovitis

De Quervain's tenosynovitis is not a serious condition, but it is a very annoying one that can limit what you're able to do, and may even affect your ability to do your job.

What can I do about it?

Rest your hand and change the way you use it

holding babyIt's important to rest your hand and thumb for four to six weeks. By doing this you let the inflammation settle, which may be enough to solve the problem. Try this first, as it works for most people.

If you can't completely rest your hand and thumb, try changing the way you use them. Changing the way you hold your hand and thumb and being aware of your general posture can help.

Avoid any repetitive or heavy activities that use your thumb and hand and make it worse. These can include things such as working in the garden, DIY tasks, carrying a baby, and some manual occupations.

Wear hand splints

A splint that stops your thumb and wrist from moving (called a thumb spica splint) can help you to rest your thumb tendons, but people often find these difficult to wear all the time. The splint keeps your thumb slightly bent, as it would naturally be when it is relaxed, and must also include your wrist to work properly.

Try wearing one at night and during any activity that makes the pain worse. The more you use the splint, the quicker you will get better, and if you wear one all the time the pain may go away in just a few weeks.

You can buy thumb splints in pharmacies, sports shops, or from a hand therapist. A hand therapist can get you a correctly fitted splint and also help with specific advice and exercises. A splint from a hand therapist may be a bit more expensive, but it should also be more comfortable and effective than one you buy in a shop.

Take pain relief

If they are safe for you to use, you can take paracetamol (Panadol) or non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Nurofen) for pain. If you're not sure whether you can take these, ask your doctor.

Once the pain has settled, avoid long periods doing anything that caused pain in the past. This reduces the chance of pain coming back.

Who can help?

If pain continues even after you have rested your hand, talk to your GP first.

General practice team

If you need to find a GP, you can search on this map.

If resting for four to six weeks doesn't work, your GP may be able to give you a steroid injection into your hand's tendon sheath to reduce inflammation. You might need a second injection if the first one doesn't help. Steroid injections work for about 70 to 80% of people, with about half of them needing only one injection, while the other half need two.

If your GP isn't experienced in giving steroid injections, they may refer you to one who is.

A hand therapist

You may wish to pay to see a private hand therapist. They can help with treatments, including exercises and wrist splints, and occupational advice.

Most of the time ACC does not fund treatment for de Quervain's tenosynovitis so you will probably have to pay.

Plastic surgeon or orthopaedic surgeon

Steroid injections are so effective that it is unlikely that you'll need surgery for de Quervain's tenosynovitis. But if you have seen a hand therapist and have had two steroid injections, and still have wrist and thumb pain, you may need surgery.

On the next page: Surgery for de Quervain's tenosynovitis

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Written by HealthInfo clinical advisers. Endorsed by clinical directors, Plastic Surgery and Orthopaedics Departments, Canterbury DHB. February 2017.

Sources

Page reference: 292003

Review key: HIWAH-240323