De Quervain Disease

WHAT YOU SHOULD KNOW:

• De Quervain's (kar-VAZ) disease is also called tenosynovitis of the wrist or washerwoman's sprain. It is a condition affecting the tendons that control the thumb. Tendons are cords of tissue that connect muscles to the bones. Tendons are enclosed in a protective sheath (covering). With de Quervain's disease, the sheath becomes narrow and the tendons thicken due to frequent, repeated movements of the thumb or wrist. De Quervain's disease usually affects women and those over 40 years of age. It is common in piano players, typists, weavers, bowlers, and wrestlers.
  
  
• You may have pain and swelling in your thumb or the wrist below the affected thumb. This pain usually occurs when moving the wrist up and down, while grasping an object, or making a fist. Over time, the pain may become worse and may be present even at rest. You may also have weakness and limited movement of your thumb or wrist. Your caregiver will test your thumb and wrist by moving it in different positions. X-rays or magnetic resonance imaging (MRI) may be done to look for tendon injuries and other problems. Treatment will depend on your symptoms and the length of time you have had them. With treatment, such as rest, medicines, a splint, rehabilitation, or surgery, you may be able to resume your normal daily activities.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
  
  
• NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Activity:

Limit the activities of your affected hand or thumb until your caregiver says it is OK. Avoid hand and wrist movements, such as twisting, grasping, or forceful gripping. You may also need to decrease your thumb pressure while pushing control buttons, typing, or playing the piano. This may help decrease stress on the tendon and prevent further damage, relieve pain, and promote tendon healing.

Rehabilitation:

• Occupational therapy: Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.
  
  
• Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Rest:

Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

Splint care:

Caregivers may put a splint on your hand and wrist. This will keep them from moving while they heal. It may also be used to decrease pain. Make sure your splint is not too tight or loose. If it is too tight, your fingers may feel numb or tingly. Gently loosen the tape so that your fingers are comfortable. Do not push down or lean on any part of the splint because it may break.

For more information:

Having de Quervain's disease may make it hard for you to continue your usual activities. It may make things difficult for both you and your family. Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

CONTACT A CAREGIVER IF:

• You have a fever.
  
  
• You have pain and swelling in your thumb or hand, even after taking your medicines.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

• You have trouble breathing or have chest pain all of a sudden.
  
  
• Your shoulder, arm, or fingers feel numb, tingly, cool to the touch, or look blue or pale.
  
  
• Your symptoms have become worse, or have returned.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about De Quervain Disease (Discharge Care)