Pain Is The Main Symptom Of De Quervains Disease
Intense stabbing pain between the thumb and wrist is the hallmark symptom of De Quervains disease.
The pain may have a gradual or sudden onset and in some cases radiate to the forearm there may also be swelling in the wrist.
Repeated use of the hand and of the thumb in particular accentuates the pain, especially in movements requiring rotation of the wrist, such as opening a jar, or when grasping objects such as a bottle or a pot.
This is particularly true for those who make forced or repetitive movements with the wrist, such as: musicians those who embroider and sew a lot those who assiduously use the computer mouse, keyboard and mobile phone mothers who breastfeed, especially in the last period when the baby becomes heavy and supporting the head requires a great deal of effort from the tendons affected by this disease.
At the time of De Quervain, the Swiss surgeon who first described this disease, it was known as the disease of nannies and embroiderers.
When Should I Call The Doctor
You should call your healthcare provider if you experience:
- Inability to move your hand, wrist or fingers.
- Pain that lasts after two weeks of at-home treatments.
- Painful tingling up or down your arm.
- Unusual redness or swelling in your forearm, wrist, hand or fingers.
A note from Cleveland Clinic
Many people experience wrist pain at some point. Outside of a sprain or fracture, carpal tunnel syndrome, tendonitis and arthritis are major causes of wrist pain. Your healthcare provider can help pinpoint whats causing your wrist pain and recommend appropriate treatments. Often, nonsurgical therapies like wearing a splint, modifying activities and doing hand exercises can ease symptoms. If wrist pain interferes with your ability to work, sleep or do daily activities, you might benefit from surgery.
Last reviewed by a Cleveland Clinic medical professional on 11/03/2017.
References
Signs Of De Quervain’s
The main symptom of de Quervain’s tenosynovitis is pain on the thumb side of the wrist the pain can sometimes radiate up the forearm. The pain may come on all at once or it may develop gradually. You will usually feel it worse when you are using your thumb when grasping something or when you are twisting your wrist. You may also feel a catching sensation when you try to move your thumb. The thumb side of your wrist may be swollen and this may make it more difficult to move it. The most common signs include:
- Pain directly under the thumb at the level of the wrist
- Swelling and tenderness at the location of pain
- Grinding sensations when moving the thumb and wrist
The examination of de Quervain’s is usually quite typical with tenderness over the involved tendons. One specific maneuver called Finkelstein’s test is quite specific for this condition, this test is performed by your physician to make a diagnosis of de Quervain’s tenosynovitis. Finkelstein’s test is performed by making a fist over your bent thumb, and moving the wrist towards the small finger. Patients with de Quervain’s tenosynovitis will have pain with this maneuver.
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What To Expect At Your Office Visit
Your provider will perform a physical exam. You will be asked about your symptoms. Questions may include when the wrist pain began, what may have caused the pain, whether you have pain elsewhere, and if you have had a recent injury or illness. You may also be asked about the type of job you have and your activities.
X-rays may be taken. If your provider thinks that you have an infection, gout, or pseudogout, fluid may be removed from the joint to examine under a microscope.
Anti-inflammatory medicines may be prescribed. Injection with a steroid medicine may be done. Surgery may be needed to treat some conditions.
When It Is An Emergency
Seek emergency severe wrist pain treatment if:
- You have any of the following symptoms after an acute injury:significant swelling tenderness to pressure at one specific spot tingling or weakness in your fingers or an abnormal angle of the wrist.
- You have the following symptoms and a fever: You have rapid-onset severe wrist pain, swelling, and warmth, and/or had a recent injury that broke the skin over the wrist.
In some cases, even though emergency care isn’t necessary, you may need evaluation and treatment.
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What Causes Wrist Pain
If you have wrist pain after a fall, an X-ray may show that you have a fracture, sprain or partial ligament disruption, but sometimes mysterious aches and pains appear. These symptoms may come and go, get worse throughout the day or never seem to go away. Finding the cause of chronic wrist pain can be a challenge. You should see your healthcare provider who will perform a careful examination and obtain appropriate imaging studies.
You may have wrist pain due to:
Unusual and rare sources of wrist pain include:
- Avascular Necrosis of a carpal bone.
- Cervical nerve compression.
Buckle Fracture Of Distal Radius
A buckle fracture of the wrist, also known as a torus fracture, is a condition that are most common in children aged 5-10 years due to the elasticity of their bones. This fracture occurs when force is applied to the radius , causing the bone to split along the growth plate.
You should visit your primary care physician within the next 24 hours. The treatment for this kind of fracture is immobilization in a cast.
Rarity: Common
Top Symptoms: constant forearm pain, forearm pain from an injury, pain in one forearm, swollen forearm, wrist injury
Symptoms that always occur with buckle fracture of distal radius:forearm pain from an injury, constant forearm pain
Urgency: Primary care doctor
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When To Contact A Doctor About Wrist Pain
Its important to contact a doctor if:
- wrist pain is interfering with everyday activities
- numbness or tingling is becoming worse, and there is little or no feeling in the fingers or hand
- simple hand movements are no longer possible
- weakness makes holding things difficult
Complications of wrist pain can include weakness and a decreased ability to carry out activities such as gripping objects and using a keyboard.
After a physical exam and symptom review, a doctor may also diagnose wrist pain and the underlying condition using:
- Medical imaging scans: A doctor may order imaging scans, including X-ray, CT, and MRI scans.
- Arthroscopy: This procedure involves a small cut on the wrist. A surgeon will then insert a small instrument with a tiny camera attached through the cut. This will produce images that allow medical professionals to assess and diagnose what is causing wrist pain.
- Nerve conduction studies: These measure how fast nerve impulses travel through the forearm, wrist, and hand regions.
Typically, doctors will only order invasive diagnosis techniques after rest and recovery from an injury have been unsuccessful.
When To See A Doctor
Hand and wrist pain often gets better with things you can do at home.
However, youll need to visit your GP surgery if:
- your pain isnt getting better after treatment at home for two weeks
- the pain is getting worse
- the pain keeps returning
- the pain is stopping you from doing your everyday activities
- your hands are stiff and swollen, particularly in the mornings and these feelings dont get better after half an hour
- as well as being swollen and stiff, your hands are warm and red
- you also feel generally unwell, especially if you have a high temperature
- you have ongoing tingling, numbness or weakness in the hands or fingers.
Its important to get urgent medical attention, if:
- you think youve broken a bone
- you have extreme pain
- any part of your hand, wrist or fingers is a funny shape or colour
- you have lost the feeling of part or all of your hand
- there was a snap, grinding or popping noise when you injured your hand or wrist
- you cant move your hand, wrist or fingers properly.
If you have ongoing hand and wrist pain or a specific condition affecting the hand and wrist it could be helpful to see a hand therapist. These are healthcare professionals with expertise in treating conditions affecting the hand and wrist. Your GP, rheumatology department or orthopaedic department could refer you to one.
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When To See A Healthcare Provider
Certain signs and symptoms can indicate a more serious cause of your wrist pain. Get medical help if you have:
- Pain that lasts more than a few days
- Inability to straighten or flex the joint
- An inability to carry objects or use the arm
- Pain at night or while resting
- A deformed joint
- A hand or fingers that are bluish
Pain Outside Of Wrist Other Causes
It is evident that many things can cause you to have pain in your wrist. Some are usually immediate while others are related to time which causes the body to lose its strength.
Whatever the cause you will see more reasons below why pain is possible in the wrist.
Arthritis
Arthritis is a common cause of pain in the wrist. It is essential to know which type of arthritis affects you as there are multiple. There is gout, osteoarthritis, and rheumatoid arthritis.
Gout is when the fluid in the joints forms crystals. Osteoarthritis results from aging, where the joints become worn out injury is another possible cause. Rheumatoid arthritis is when the joints are inflamed and damaged.
Symptoms of these types of arthritis are primarily associated with pain however, weight loss and fatigue are possible. The primary treatment for arthritis is the elimination of inflammation.
The natural way is with turmeric, ginger, and other anti-inflammatory foods. You can also buy anti-inflammatory medication. Persons also use various rubs to help and exercise some foods help rebuild cartilage which can help.
Wrist Fracture
A more severe condition of the wrist is a fracture. If your bones are weak, that could lead to an injury like this. Like the other injuries mentioned earlier, you can hurt yourself if you fall or try to catch something like a ball.
Simple movements like these can cause fractures. The wrist is a fragile part of the body, so it doesnt take much to injure it.
Medical Disclaimer
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Avoid Tasks That Make The Pain Worse
Try to avoid tasks that are causing the pain or making it worse. This may be anything that has a repetitive nature, such as using a screwdriver, painting or lifting heavy objects. You might be able to change the way you do some tasks to take the strain off your hands and wrists. Some conditions affecting the hand and wrist wont get better until you stop doing certain tasks.
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This Is The Characteristic Symptom Of De Quervains Disease A Pathology That Affects The First Finger Of The Hand: The Thumb
De Quervains disease is characterised by an inflammatory process in the sheath that covers two of the tendons that allow the thumb to move: the long abductor, which allows the thumb to move away from the other fingers, and the short extensor, which allows it to extend.
Inflammation results in swelling of the tissues around the tendons and a change in volume that prevents the tendons from flowing as they should within the canal that contains them.
When Hand Or Wrist Pain May Mean Arthritis
Learn about the various causes of hand or wrist pain, including different kinds of arthritis.
Many forms of arthritis and related conditions that affect different parts of the hands. Common symptoms include pain, stiffness, swelling or numbness in the wrist and fingers. Pitted nails, painful ulcers or thickened skin that makes bending the fingers difficult may also occur. Here are some diseases that affect the hands.
Osteoarthritis
Osteoarthritis is the most common form of arthritis. Also known as wear and tear arthritis, OA is a chronic condition caused by the breakdown of the cartilage, which cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub together, causing stiffness, pain and loss of joint movement.
In hand OA, the joints most commonly affected by OA are the wrists, the joints at the base of the thumb, the middle finger joints and the joints closest to fingernails. In the finger joints, OA can lead to the formation of nodes .
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic inflammatory disease caused by a faulty immune system that primarily attacks joints . The result can be joint pain, swelling, inflammation and loss of function. RA commonly affects the wrist and finger joints. RA usually affects the same joint on both sides of the body . If untreated, the disease can cause joint deformities that make it difficult to use the hands.
Juvenile Arthritis
Lupus
Psoriatic Arthritis
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De Quervains Tenosynovitis Vs 1st Cmc Joint Arthritis
Both present as thumb pain often on the dorsoradial side. Differentiate the two by a positive Finkelsteins test or reproduction of pain by grinding the thumb like a mortar and pestle . Treatment for both is NSAIDS and rest using a thumb spica splint. Steroid injections are effective.
Dont brace for too long with CMC arthritis because muscle wasting and joint stiffness may result!
Hand Foot Wrist And Ankle Pain Myositis And Myopathy: A Rapid Review
Recap and review the top pearls from recent episodes #339 Hand and Wrist Pain, #348 Foot and Ankle Pain, and #351 Myopathy and Myositis with Watto and Paul. Its Tales from the Curbside! , our monthly series providing a rapid review of recent Curbsiders episodes for your spaced learning.
Note No CME for this mini-episode but visit curbsiders.vcuhealth.org to claim credit for shows #339, #348 and #351!
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Hand And Wrist Pain: What Causes It What Can You Do About It
In this day and age of smartphone texting, video game controllers, computers – the keyboard, mouse and even the mousing surface on our laptops – its no wonder so many people have pain in their hands and wrists.
Made of dozens of small bones, our hands and wrists can easily get sore. The wrist alone has eight bones lined up, four on top, four below. All eight bones are connected by ligaments that keep the joints together, while giving a wide range of motion for our hands. There are also many tendons that pass the wrist. These control the motion of our wrist, fingers, and thumb. Because each of those parts serves a purpose in movement, if even one area in the wrist gets inflamed or injured, youre going to feel it.
Injuries or conditions affecting the hands can make tasks that were once simple no-brainers painful and difficult. Something as mundane as lifting a coffee cup or brushing your teeth can shoot pain through your arm. The pain may even cause you to change the way you do things, such as buttoning a shirt, tying a shoelace and even signing your name.
Arthritis, carpal tunnel syndrome, tendonitis, ganglion cysts and injuries are some of the most common conditions affecting the wrist and hand. Developing any of these conditions, especially carpal tunnel syndrome, is possible for almost anyone.
Treatment for injuries can vary from icing it at home to a visit to the emergency center.
How Is Wrist Pain Treated
Treatments for wrist pain vary depending on the cause. Depending on the severity, you may need a protective splint or cast for a fracture. If the fracture is unstable, you may require surgery. Wearing an extended support such as a cast, brace or splint can ease the pain brought on by a sprain, carpal tunnel syndrome or arthritis. Surgical intervention provides internal support.
For chronic, severe pain, your healthcare provider may recommend:
- Oral and/or injected medications to relieve symptoms.
- Carpal tunnel surgery to release pressure on the median nerve.
- Surgical release of compressed tendons.
- Surgery to ease bone-on-bone contact from arthritis. This can include motion-preserving procedures such as potential wrist fusion, bone removal or total or partial wrist replacement.
- Removal of the inflamed tissue . Your surgeon may use an open or arthroscopic technique.
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What Is Wrist Pain