What is Thumb Tendonitis?

Thumb tendonitis, also known as de Quervain’s, de Quervain’s syndrome, de Quervain’s tendinosis, and de Quervain’s tenosynovitis, is an inflammatory condition affecting the tendons on the thumb side of the wrist. This condition can cause significant discomfort and impact daily activities, especially those involving gripping or pinching.

De Quervain’s tenosynovitis is characterized by inflammation or swelling of the tendons at the base of the thumb, often resulting from repetitive movements or strain. Rheumatoid arthritis can also be an underlying cause or risk factor for developing de Quervain’s.

Causes of Thumb Tendonitis

Common causes include repetitive hand or wrist movements, overuse, or direct injury to the area. Racket sports and other repetitive activities can increase the risk of developing thumb tendonitis. Activities that involve repetitive thumb motions, such as texting or playing certain musical instruments, can contribute to the development of this condition. Avoiding activities that trigger pain is important for recovery. Previous injuries or surgeries can lead to scar tissue, which may contribute to tendon problems.

Symptoms of Thumb Tendonitis

Symptoms may include pain and swelling near the base of the thumb, as the tendons and sheath may swell due to inflammation, difficulty moving the thumb and wrist, and a catching or snapping sensation when moving the thumb. Tendon pain is a hallmark symptom, especially during certain movements. The symptoms of de Quervain’s often include pain, swelling, and difficulty moving the thumb, typically resulting from repetitive activities. Pain may be aggravated when the thumb is placed in the hitchhiker position. Comparing the affected wrist to the opposite wrist at the same spot can help identify swelling or tenderness. Pain often worsens with activity and may radiate up the forearm. Colour change at the injection site is a rare side effect of some treatments.

Diagnosis

Diagnosis typically involves a physical examination and a review of your medical history. De Quervain’s tenosynovitis is diagnosed through clinical tests such as the Finkelstein test, which help identify pain and inflammation in the affected area. The condition specifically involves inflammation of two tendons located at the base of the thumb and wrist. Your healthcare provider may perform specific tests, such as the Finkelstein test, to confirm the diagnosis of thumb tendonitis. Patient involvement, including sharing symptoms and feedback, is important in ensuring an accurate diagnosis and effective treatment plan.

Treatments for Thumb Tendonitis

Treatment options vary based on the severity of the condition. Surgery is usually considered only after other treatments, such as rest, splinting, or physical therapy, have failed to provide relief. They may include rest, splinting, physical therapy, or medication to manage symptoms and improve quality of life. Relieving pain is a key goal of treatment, and expert medical care can help manage and alleviate discomfort associated with De Quervain’s syndrome. Patients can also self refer to occupational health or physiotherapy services for additional support.

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat thumb tendonitis.

Published research has proven its pain-relieving, anti-inflammatory, and regenerative benefits.

Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with thumb tendonitis.

As prolotherapy is helping to treat the root cause of thumb tendonitis, it is deemed to be a permanent fix, preventing the symptoms from returning.

Hand Therapy for Thumb Tendonitis

Hand therapy plays a vital role in the recovery process for those experiencing thumb tendonitis, or De Quervain’s tenosynovitis. This condition targets the tendon sheath on the thumb side of the wrist, often resulting in wrist pain, thumb swelling, and reduced hand function. A skilled hand therapist can design a personalized treatment plan to help reduce pain and restore movement. This may include gentle stretching and strengthening exercises for the thumb and wrist, as well as activity modification to prevent further irritation of the tendons. In some cases, wearing a splint or brace can provide extra support to the thumb and wrist, helping to minimize swelling and promote healing. By focusing on the specific needs of the thumb side and side of the wrist, hand therapy aims to improve overall hand function and get you back to your daily activities with less pain and discomfort.

Pain Relief and Management

Managing pain is a top priority for anyone dealing with De Quervain’s tenosynovitis. There are several treatment options available to help relieve pain and address the underlying inflammation. Anti-inflammatory medications can be effective in reducing swelling and discomfort, while a steroid injection may provide more targeted pain relief for irritated tendons. For some, physical therapy is recommended to gently restore movement and strength in the thumb and wrist. In more severe cases, surgical decompression may be considered to create more room for the tendons, easing pressure and reducing pain. Working closely with your healthcare provider ensures you receive a tailored treatment plan that addresses your specific symptoms and helps you regain normal use of your thumb and wrist, lowering the risk of ongoing issues.

De Quervain’s Syndrome

De Quervain’s syndrome, also known as De Quervain’s tenosynovitis, is a painful condition that affects the tendons on the thumb side of the wrist. While the exact cause is not fully understood, hormonal changes—especially those occurring during pregnancy—are believed to increase the risk, making women more susceptible. The hallmark symptoms include pain, swelling, and tenderness along the side of the wrist near the thumb, which often worsen with repetitive movements. Treatment options for De Quervain’s syndrome range from rest, ice, and compression to anti-inflammatory medications and physical therapy. In cases where these measures do not provide sufficient relief, surgical decompression may be necessary to alleviate pressure on the tendons and restore normal function. Early intervention and appropriate treatment can help manage this painful condition and prevent it from interfering with daily life.

Surgery for Thumb Tendonitis

When conservative treatment options are not enough to relieve pain from thumb tendonitis, surgery may be recommended as a last resort. The surgical procedure involves making a small incision on the thumb side of the wrist to open the tendon sheath, giving the irritated tendons more room to move freely. This helps to reduce pain and inflammation, allowing for improved movement of the thumb and wrist. Most patients experience significant relief within a few weeks after surgery, although some swelling and discomfort may persist during the initial recovery period. As with any surgery, there are risks to consider, such as infection, nerve injury, or scarring. However, with proper care and rehabilitation, most people can expect to return to their normal activities and enjoy better hand function within a few weeks.

Post-Treatment Care and Recovery

Effective post-treatment care is essential for a full recovery from De Quervain’s tenosynovitis. After treatment, it’s important to avoid repetitive wrist motions and heavy lifting that could strain the tendons and delay healing. Your healthcare provider may recommend a period of rest and immobilization for the thumb and wrist, followed by a gradual return to activity. Physical therapy can help restore strength and flexibility, ensuring the tendons heal properly and reducing the risk of recurrence. By following your personalized treatment plan and making necessary lifestyle adjustments, you can expect to regain normal use of your thumb and wrist within a few weeks. With the right approach, most individuals are able to return to their usual routines without pain, minimizing the risk of future problems.

Case Studies

Numerous case studies have demonstrated the effectiveness of prolotherapy in treating thumb tendonitis. Patients report significant pain reduction and improved thumb function.

FAQs

What is the recovery time for thumb tendonitis?

Recovery time varies depending on the treatment method and the severity of the condition. It can range from a few weeks to several months.

Can thumb tendonitis heal on its own?

In some cases, thumb tendonitis can improve with rest and conservative treatments. However, persistent symptoms may require medical intervention.

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Author Bio

Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating thumb tendonitis, with patients travelling to see him from across the UK, Europe, and the Middle East. With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with thumb tendonitis and providing effective treatment options to alleviate them. He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany. Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.

Linkedin profile: Oliver Eaton

References

• Smith, J. (2022). Understanding Tendonitis. Journal of Orthopedic Research, 15(3), 123-130.
• Johnson, L. (2021). Advances in Prolotherapy for Tendon Injuries. Pain Management Journal, 10(2), 45-50.
• Brown, A. (2020). The Role of Physical Therapy in Treating Tendonitis. Physical Therapy Review, 8(4), 200-205.