De Quervain’s Syndrome especially by lifting the , as in the physiotherapist. It needs to immobilize the hitchhiker position or when using scissors. thumb as well as the .

2. Tenderness if you press on the site of pain. 3. Steroid injection relieves the pain in about 70% of cases. The risks of injection are small, 3. Swelling of the site of pain – compare it with but it very occasionally causes some thinning same spot on the opposite wrist. or colour change in the skin at the site of injection. 4. Clicking or snapping of the occurs occasionally. 4. Surgical decompression of the

tunnel. The anaesthetic may be local (injected Diagnosis? What is it? under the skin at the site of operation), Finkelstein’s test is often positive. regional (injected in the armpit to numb the De Quervain's syndrome is a painful condition entire arm) or a general anaesthetic. that affects tendons where they run through a De Quervain’s is a clinical tunnel on the thumb side of the wrist. diagnosis, with no investigations required. Through a transverse or longitudinal incision, However, a plain hand radiograph may be and protecting the nerve branches just under What is the cause? used to exclude other diagnoses (such as CMC the skin, the surgeon widens the tendon tunnel by slitting its roof. The tunnel roof It appears without obvious cause in many joint arthritis) forms again as the split heals, but it is wider cases. Mothers of small babies seem What is the treatment? and the tendons have sufficient room to move particularly prone to it, but whether this is due without pain. to hormonal changes after or due to De Quervain’s syndrome is not harmful, but it lifting the baby repeatedly is not known. There can be a really painful nuisance. Milder cases Pain relief is usually rapid. The scar may be is little evidence that it is caused by work recover over a few weeks without treatment. sore and unsightly for several weeks. Because activities, but the pain can certainly be the nerve branches were gently moved to see Treatment options are: aggravated by hand use at work, at home, in the tunnel, transient temporary numbness can the garden or at sport. 1. Avoiding activities that cause pain, if occur on the back of the hand or thumb. Other risks are the risks of any such as What are the symptoms? possible infection (less than one in 100 risk) or stiffness 1. Pain on the thumb side of the wrist, as 2. Using a wrist/thumb splint, which can often shown in the diagram. Pain is aggravated be obtained from a sports shop or a