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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

If De Quervain's disease is diagnosed early in its course then conservative therapy with avoidance and modification of exacerbating movements plus thumb splints may be all that is required.

  • management: (1)
    • involves avoidance and modification of exacerbating thumb and wrist movements
      • thumb splints (spicas) can provide immediate relief
        • essential when prescribing a splint to make sure it is a specific thumb splint rather than a wrist splint that does not immobilise the thumb
        • to avoid confusion it is best to prescribe a 'thumb spica' rather than a splint.
        • these should be used for 4-6 weeks along with a course of NSAIDs
      • in resistant cases a corticosteroid injection into the tendon sheath is often very effective. (2) Resistant cases can be referred for ultrasound-guided injections or surgical decompression which may be done endoscopically (3)
        • if the condition is chronic then an operation may be required which involves slitting the thickened lateral wall of the tendon sheath (3)

References:

  1. Arthritis Research UK (April 2013). The upper limb in primary care. Part 2: Wrist, hand. Hands On 2(7).
  2. Cavaleri R, Schabrun SM, Te M, et al. Hand therapy versus corticosteroid injections in the treatment of de Quervain's disease: a systematic review and meta-analysis. J Hand Ther. 2016;29:3-11.
  3. Kang HJ, Koh IH, Jang JW, et al. Endoscopic versus open release in patients with de Quervain's tenosynovitis: a randomised trial. Bone Joint J. 2013;95-B:947-951.

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