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 list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
  
  
• Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (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 your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

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 play activities to help you in your daily life. OT teaches special skills for bathing, dressing, cooking, eating, or driving. An occupational therapist may help you choose tools to use, and suggest ways to keep your home or workplace safe. You and your therapist will plan a therapy program that is right for you.
  
  
• Physical therapy: Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises help make your bones and muscles stronger.

Rest: You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed.

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
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont, IL 600184262
  Phone: 1-847-8237186
  Web Address: http://www.aaos.org/
  

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• 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 © 2008 Thomson Healthcare Inc. 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.

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