De Quervain’s Disease is a painful thickening of tendons that move your thumb away from your hand. If you have de Quervain’s it will likely hurt on the thumb side of your wrist, sometimes the pain will travel up into the thumb. It will probably hurt when you do things like lifting up your baby, using a hammer or even pulling up trousers. Any activity that involves thumb use with sideways wrist movement at the same time can be very painful.
What is happening?
We have three tendons that move the thumb away from the palm. They are held in place at the wrist by connective tissue. This tissue is known as the first dorsal compartment. The tendons are supposed to glide through this compartment nice and smoothly. When we overuse these tendons by repetitive movements, the tendons and compartment get inflamed and swell. This then restricts the compartment making it painful for the tendons to glide through as they cant fit properly. In severe cases the tendons can actually get stuck in the compartment, causing the thumb to get stuck or the movement can be ‘jerky’.
Every time we move the thumb away from the hand it moves the tendons through the compartment. This movement keeps flaring up the inflammation and essentially keeps making the pain and condition worse.
What can we do about it?
Firstly we have to stop the cycle of inflammation. This generally means we have to rest the tendons. There are lots of options to do this, ranging from custom made thermoplastic splints, to taping, to neoprene braces. The type of splint or support is individual to each person.
The splint generally needs to be worn for 3-6 weeks. I know the splint is annoying but it will almost immediately ease your pain. Sounds pretty good doesn’t it?
The other thing I love about wearing splints for this condition is that it is a great forced learning tool! The splint will stop you from doing the movements that caused the condition in the first place. It will then help you to learn new movement patterns which will help prevent the condition from coming back.
The key to your recovery from de Quervain’s is in learning about what caused it in the first place and then changing how you do those things to take the load off the tendons. If you go back to overusing the tendons the same way you did before treatment, the condition will come back.
I urge you to seek treatment as soon as you can – the quicker you get good treatment the sooner you can go back to taking your hand for granted!