WHAT YOU NEED TO KNOW:

What is de Quervain's disease? De Quervain's disease is inflammation of the tendons on the thumb side of your wrist. Tendons are thick strands of tissue that connect muscles to bones.

What causes de Quervain's disease? De Quervain's disease is usually caused by frequent, repeated movements of your thumb or wrist. For example, lifting a small child, sewing, typing, or playing the piano can cause inflammation. A direct blow to the thumb may also damage the tendon and form scar tissue. This scar tissue can keep the tendon from working properly.

What are the signs and symptoms of de Quervain's disease?

• Pain and swelling near the base of your thumb are the most common symptoms. This usually occurs when you move your wrist up and down, grasp an object, or make a fist.
  
  
• You will hear a grating noise when you move or rub your thumb or wrist.
  
  
• Your thumb and wrist may be weak and you may have limited movement.

How is de Quervain's disease diagnosed? Your healthcare provider will ask about your medical history and examine you. He will ask you to make a fist with your thumb touching the palm of your hand. Then he will ask you to move your hand and wrist in certain directions. He will check to see if you have pain, weakness, or problems with movement. Both hands may need to be checked. You may also need any of the following:

• X-rays: You may need pictures of your wrist and hand to check for a fracture. X-rays of both hands and wrists may be done.
  
  
• MRI: This scan uses powerful magnets and a computer to take pictures of your wrist and hand. An MRI may show if you have de Quervain's disease. You may be given dye to help the pictures show up better. Tell healthcare providers if you are allergic to iodine or seafood. You may also be allergic to the dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell healthcare providers if you have any metal in or on your body.

How is de Quervain's disease treated?

• Medicines:
  • NSAIDs: These medicines decrease swelling, pain, and fever. They are available without a doctor's order. Ask which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
    
    
  • Steroid injection: This decreases long-term pain and swelling. It is usually injected into your wrist or hand.
  
  
• Surgery: This may be done if other treatments do not work or your pain interferes with your daily activities. During surgery, an incision is made in the tissue that covers the tendon. This helps release pressure and reduce pain so your tendon can move freely.

How can I manage my symptoms?

• Splint or brace: These devices will help decrease pain, limit movement, and protect your wrist so that it can heal. Make sure your device is comfortable. If it is too tight, your fingers may feel numb or tingly. Do not push or lean on your device because it can break.
  
  
• Physical or occupational therapy: You may need to see a physical or occupational therapist to teach you special exercises. These exercises help improve movement and decrease pain. They also help improve strength and decrease your risk for loss of function. Therapists will help you make changes to your daily activities to decrease stress and pressure on the tendons.
  
  
• Rest: Rest your injured thumb or wrist. Avoid twisting, grasping, or gripping movements. Ask when you can return to your normal activities.

What are the risks of de Quervain's disease?

• Your thumb or wrist may not move the way it did before, even after treatment. It may take time and commitment to therapy to regain strength and normal movement of your thumb and wrist.
  
  
• Without treatment, you may have increased pain and swelling. Over time, your movement and function will decrease. Eventually, you may not be able to move or use your thumb or wrist.

When should I contact my healthcare provider?

• Your splint or brace is too tight and you cannot loosen it.
  
  
• You have a fever.
  
  
• Your pain and swelling get worse or do not go away.
  
  
• Your cannot grasp objects because of the pain and swelling.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

• You cannot move your thumb or wrist.
  
  
• Your fingers feel numb, tingly, cool to the touch, or look blue or pale.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.