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Treating de Quervain's tenosynovitis

A person with de Quervain's tenosynovitis wearing a wrist splintDe 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. There are several things you can do to treat de Quervain's tenosynovitis.

Rest your hand and change the way you use it

It's important to rest your hand and thumb for four to six weeks. This should reduce the inflammation, 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 using them differently. 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 work.

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. The splint keeps your thumb slightly bent, as it would naturally be when it is relaxed. It must also include your wrist to work properly.

People often find these difficult to wear all the time, but if you can, the pain may go away in just a few weeks. 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.

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 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 gone away, avoid long periods doing anything that caused pain in the past. This reduces the chance of pain coming back.

Have a steroid injection

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. About half of them need only one injection, while the other half need two.

Your GP will either give the injection themselves, or refer you to another GP or specialist for this treatment.

Have surgery

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

Surgery for de Quervain's tenosynovitis is not usually available through the public health system. However, it may be available in severe or disabling cases.

You may choose to pay to see a a private plastic surgeon or private orthopaedic surgeon to find out if surgery will help you. Ask your GP to refer you.

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

Written by HealthInfo clinical advisers. Endorsed by clinical directors, Plastic Surgery and Orthopaedics Departments, Canterbury DHB. Last reviewed April 2021.

Sources

Page reference: 292003

Review key: HIWAH-240323