Consumer Information

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.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

Medicines may cause you to have stomach ulcers (sores), nausea (upset stomach), or vomiting (throwing up). You could get an infection or bleed too much with surgery. Sometimes, even after treatment, the thumb or wrist may not move the way it did before treatment. Rehabilitation may take some time.
If left untreated, de Quervain's disease may cause further problems with using your hands and wrists. You may not be able to do your usual activities. The chances of treating de Quervain's disease are better when it is diagnosed and treated as early as possible. Completing your rehabilitation program is also very important. Ask your caregiver if you have concerns about your condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Medicines: Your caregiver may give you the following kinds of medicines:

Medicines for pain, swelling, or fever: You may be given medicines to treat pain, swelling, or fever while you are in the hospital. These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease, a history of bleeding in your stomach, or any other medical problems. Also tell your caregiver about any allergies you have to medicines. Tell your caregiver about all other medicines, herbs, and supplements that you have taken lately.
Steroid medicine: Your caregiver may suggest steroids be injected into your wrist or hand. This medicine decreases chronic (long-term) pain and swelling.

Tests: You may have one or more of the following:

Physical exam: Your caregiver may have you make a fist with your thumb touching the palm of your hand. Your palm is the inside of your hand. While your hand is in this position, he will ask you to move your hand and wrist in certain directions. Your caregiver will check to see if you have pain, weakness, or any movement problems. Both hands may need to be checked for any pain or movement problems.
X-rays: You may need x-rays of your wrist, hand, and forearm to check for broken bones or other problems. X-rays of both your painful and non-painful hands and wrists may be taken.
Magnetic resonance imaging scan: This is also called an MRI. An MRI uses magnetic waves to take pictures of the forearm, wrist, and hand area. This may help your caregiver decide if you have de Quervain's disease, or another condition that is affecting your hand and wrist.

Treatment options: Your treatment may change if your health problem is not being controlled. This is often decided after you have tests. You may have some of the following treatments alone or together.

Immobilization: Immobilization (keeping your wrist from moving) is an important treatment that allows the wrist to heal.
Splint: A splint may be used on your thumb and wrist to decrease pain and prevent the tendons from being damaged further.
Surgery: You may need surgery if your symptoms do not go away with treatment, such as medicine. Surgery may also be done if your pain gets worse or is so severe (bad) that it affects your daily activities.
Rehabilitation: This is a program that may include physical and occupational therapy to help your condition heal faster. When the swelling has gone down, you may be given exercises to do. These exercises aim to bring back the normal range of motion of your hand or thumb, and will also strengthen your tendons. Your caregiver may also ask you to make changes in your activities to decrease stress on the tendons. These changes may also prevent this condition from happening again.

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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