De Quervain's disease is a painful wrist condition that affects the tendons on the thumb side of the wrist (the radial side). Symptoms may include pain or tenderness when moving the thumb, turning the wrist, grasping something, or making a fist. Pain may radiate to the thumb or forearm. Some people have swelling on the radial side of the wrist or difficulty holding objects.
The cause of de Quervain's disease is poorly understood. Symptoms result from entrapment (compression) of the tendons in the affected area. Two tendons in the wrist and lower thumb normally glide smoothly through a tunnel connecting them to the thumb. If the area around the tendons becomes irritated, swelling may restrict their movement. The condition is often attributed to occupational or repetitive activities involving extending the thumb. It is most common among women between the ages of 30 and 50, including women who have recently had a baby or others who repetitively lift infants. It may also develop in people who have sustained direct trauma to the affected area.
Treatment for de Quervain's disease may first involve splinting of the thumb and wrist, or corticosteroid injections to reduce inflammation. If injection therapy fails, surgery can relieve the entrapment.
Source: GARD Last updated on 05-01-20
Recurrence of symptoms of de Quervain's disease after surgical treatment has been reported. One possible explanation when surgery does not result in a decrease of symptoms is that the initial diagnosis was incorrect. Another possible explanation is that there may have been incomplete release (continued entrapment) during surgery. Failure to recognize and release an additional compartment (most commonly of the extensor pollicis brevis tendon, or EPB) can lead to persistent pain from the EPB remaining entrapped. If repeat cortisone injections do not relieve symptoms, careful surgical re-exploration may allow a previously overlooked tendon to be released.
We are not aware of published reports specifically describing recurrence several years after surgery. However, this does not mean that such cases do not exist. Most series have been unable to identify risk factors for long-term complications.
For information about the long-term outlook associated with de Quervain's disease and possible complications of surgery, read our information about prognosis.
People with persistent or recurring symptoms of de Quervain's disease are encouraged to speak with their medical provider.
Last updated on 05-01-20
De Quervain's disease does not affect the lifespan. If the condition is not treated, there may be progressive pain, difficulty using the hand and wrist properly, and/or limited range of wrist motion. Most patients respond very well to nonsurgical treatment. Some people who have been successfully treated with injections may have recurrent symptoms when they return to lifting infants. Relief is usually permanent after successful surgery.
Complications from surgery, or after surgery, are possible. Potential complications may include:
Additional reported complications include scar hypertrophy or tenderness (particularly with longitudinal incisions), reflex sympathetic dystrophy, and continued pain as a result of incorrect diagnosis. Associated diagnoses that may have been missed include basilar arthritis of the thumb, instability of the thumb, intersection syndrome, and radial neuritis. Wartenburg's syndrome (ie, superficial radial neuritis) has been shown to negatively affect surgical outcome for de Quervain's disease.
Last updated on 05-01-20
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