Thumb Tendonitis or De-Quervain's syndrome is the inflammation of the thumb tendons caused by repetitive motion. It is a condition in which the tendons around the base of the thumb get inflamed leading to pain, swelling and even weakness in the joint.

CAUSES

*Main cause is the repetitive movements of the thumb and wrist. Eg. gripping, lifting objects, keeping the thumb in one position, wringing wet clothes.

*Direct injury to the thumb or wrist.

*Seen in new mothers as they keep straining the joint with the infant.

*Some inflammatory conditions like rheumatoid arthritis may also be the cause.

SYMPTOMS

* Pain is felt at the base on the thumb side of the wrist. It may radiate till the forearm.

* The pain worsens with the thumb and wrist movements. Pain is generally associated with swelling.

* Pain and stiffness affect the range of movement of the thumb and the wrist.

* Weakness in the thumb and difficulty in lifting weight.

Seen in the age groups generally between 30-50. Women are more affected.

EXAMINATION

FINKELSTEIN TEST

Place your thumb against your hand,make a fist with your fingers closed over the thumb. Now bend the wrist towards your little finger.  The test is positive for De-Quervain's tendinosis if it hurts on the thumb side of the wrist.

TREATMENT(Conservative/ Non-Surgical)

* Avoid activities that cause pain.

* SPLINTS-Splinting can be done to hold the thumb and wrist. This avoids the painful movements and provides rest.

* ICING- ice the area to reduce inflammation.

* Anti inflammatory medications help to reduce pain and swelling.

PHYSIOTHERAPY

* Modalities like laser therapy, ultrasound therapy and cold packs help in relieving pain and inflammation.

* Exercises are very helpful in - Reducing inflammation, Improve the range of movement & Strengthen and hence  prevents the recurrence.

* Exercises should be done under the supervision of the physiotherapist, and then continued at home as per the home programme. These would include the thumb movements like - thumb lifts, thumb opposition and thumb flexion.

Also wrist strengthening is important and can be done by wrist flexion, wrist extension, wrist ulnar and radial deviation.

* Must to be done are the grip strengthening exercises and finger exercises using a finger exerciser or a rubber band.

If you have taken all these measures to alleviate the pain and it is not responding then your ortho would recommend for a corticosteroid  injection or surgery.