De Quervain's disease


De Quervain's is a painful condition caused by the friction of tendons running through a tight tunnel on the thumb side of the wrist.
The condition can occur gradually or suddenly after an injury or an unaccustomed period of intense use of the hand. The main symptom is pain in the part of the wrist nearest the thumb, which gets worse as you use the hand and thumb. There may also be swelling in the wrist and a 'creaking' sensation when the thumb is moved.


Symptoms of De Quervain’s.

1. Pain on the thumb side of the wrist. Pain is aggravated especially by heavy gripping and twisting movements of the thumb/hand;

2. Swelling and tenderness at the site of pain;

3. Clicking or snapping of the tendons occurs occasionally.


Treatment for De Quervain’s

1. Avoiding activities that cause pain where possible;

2. Using a wrist/thumb splint to immobilise the area and a steroid injection to decrease the pain and swelling;

3. Surgical decompression of the tunnel eliminates friction and allows the tendons to glide smoothly again.


How successful is the treatment?

Non-surgical treatment avoiding provoking activities or using splints, tablets or injections can be very helpful for many patients with De Quervain’s disease. If the condition progresses and affects your quality-of-life, surgery may be required.

What are the risks and benefits of surgery?

Surgery is restricted to those patients where nonoperative measures are unsuccessful. Although surgery has a relatively high success rate, it does not always relieve symptoms. A small percentage of patients (1% or less) will develop a severe reaction after hand surgery (called CRPS), with long-standing pain and loss of use in the hand which is something that is difficult to treat. If you are concerned about any of these risks, or have any further queries, please speak to Mr Miller. 


When will I be able to drive after the operation?

You are advised not to drive for at least 1-2 weeks after surgery.

How long will I be off work?

Depending on the type of work you do (manual versus office type work), and whether your dominant hand is involved, you may be off work for between 3-6 weeks after surgery.