Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028
HandSport Surgery Institute
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De Quervain Syndrome Treatments

Introduction to De Quervain Syndrome

De Quervain Syndrome, also known as De Quervain’s Tenosynovitis, is a condition that affects the tendons on the thumb side of the wrist. These tendons become inflamed, causing pain and difficulty with thumb and wrist movement. For active New York City residents—whether you’re a parent lifting children, a professional constantly using a smartphone, or an athlete—De Quervain Syndrome can significantly impact daily activities. Early diagnosis and treatment are crucial to prevent worsening symptoms and to maximize functionality of the wrist and thumb.

Causes and Symptoms of De Quervain Syndrome

Recognizing the causes and symptoms of De Quervain Syndrome can help in seeking early treatment and preventing long-term complications:

  • Common Causes:
    • Repetitive Motion: Activities that involve repeated wrist and thumb movements, such as texting, typing, and gaming, can lead to overuse of the tendons and inflammation in a predisposed individual.
    • Overuse: Overuse from manual tasks like lifting, gardening, or playing musical instruments can cause chronic irritation of the tendons.
    • Injury: A direct injury or trauma to the thumb or wrist can trigger inflammation, leading to the development of De Quervain’s Tenosynovitis.
    • Hormonal Changes: Pregnancy and hormonal shifts, which cause fluid retention, may also contribute to tendon irritation in some individuals.
  • Key Symptoms:
    • Pain and Swelling: The most common symptom is pain along the thumb side of the wrist. The pain may radiate up the forearm and worsen with thumb movement. Swelling in this area is also common.
    • Difficulty Moving the Thumb: Patients often report pain and stiffness when moving the thumb or wrist, especially when gripping or pinching objects.
    • Tenderness: Tenderness along the base of the thumb and wrist is typically present, making it painful to press on the area.
    • Crepitus: In some cases, there may be a sensation of grinding or creaking when moving the thumb due to tendon irritation.

Diagnosis of De Quervain Syndrome

At HandSport Surgery Institute in New York City, diagnosing De Quervain Syndrome begins with a detailed evaluation by our hand and wrist experts, Drs. Mark and Jason Pruzansky. Accurate diagnosis is the key to effective treatment and recovery.

  • Physical Examination: During your initial consultation, the hand surgeon will examine the wrist and thumb for swelling, tenderness, and limited movement. A common test known as Finkelstein’s Test may be performed, where the patient is asked to bend the thumb across the palm and close the fingers over the thumb while the wrist is bent towards the pinky side. Pain during this movement is a strong indicator of De Quervain Syndrome.
  • Diagnostic Imaging:
    • X-rays: Although X-rays do not show tendon inflammation, they are often used to rule out other issues such as bone spurs, calcifications, fractures or arthritis, which can cause similar symptoms.
    • Ultrasound: An ultrasound is a quick and non-invasive way to visualize the inflamed tendons and determine the severity of the condition.
    • MRI: In some cases, an MRI may be ordered to provide a more detailed view of the tendons and surrounding tissues, particularly when the diagnosis is unclear.

Receiving a thorough diagnosis from an experienced hand surgeon ensures that the most appropriate treatment plan is developed for your condition.

Non-Surgical Treatment Options for De Quervain Syndrome

Non-surgical treatments are often effective for managing De Quervain Syndrome, especially when diagnosed early. These treatments aim to reduce inflammation and alleviate symptoms without the need for more invasive procedures:

  • Indications for Non-Surgical Management: Non-surgical treatments are typically recommended for patients with mild to moderate symptoms or those who seek treatment soon after symptoms begin.
  • Conservative Treatments:
    • Rest and Activity Modification: Limiting activities that involve repetitive thumb and wrist movements is crucial. This includes modifying how you perform daily tasks, such as typing, texting, or lifting, to avoid aggravating the condition.
    • Immobilization: A splint or brace may be used to keep the thumb and wrist in a neutral position, reducing strain on the tendons. Immobilization allows the inflamed tendons to heal more effectively, especially at bed time.
    • Physical Therapy: A program of physical or occupational therapy and stretching exercises can help restore flexibility and strength in the wrist and thumb. Therapy focuses on reducing inflammation and improving range of motion.
    • Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation. In more severe cases, corticosteroid injections may be recommended to provide longer-lasting relief from inflammation.
  • Expected Outcomes: With proper adherence to non-surgical treatments, most patients experience significant improvement within 4 to 6 weeks. Non-surgical treatments are effective for the majority of cases, especially when the condition is addressed early.

Surgical Treatment Approaches to De Quervain Syndrome

For patients with severe or chronic De Quervain Syndrome that doesn’t improve with conservative treatment, surgery may be necessary to minimize pain and maximize thumb and wrist function.

  • Criteria for Surgical Intervention: Surgery is typically recommended when non-surgical treatments fail to provide relief or if symptoms persist for an extended period. Patients with significant tendon thickening or chronic inflammation may also be good candidates for surgery.
  • Surgical Techniques:
    • Tendon Release Surgery (Decompression): This procedure, also known as De Quervain Release, involves making a small incision in the affected tendon sheath to relieve pressure and allow the tendons to move more freely. By opening the sheath, the inflammation is reduced, and the tendons can glide smoothly again.
  • Benefits of Seeking Surgical Treatment at HandSport Surgery Institute: At HSSI, NYC’s top hand surgeons Drs. Mark and Jason Pruzansky specialize in minimally invasive techniques to treat De Quervain Syndrome. With years of experience in hand and wrist surgery, they offer customized treatment plans that maximize recovery and minimize downtime.

Postoperative Care and Rehabilitation

Following surgery for De Quervain Syndrome, proper postoperative care and rehabilitation are essential to optimize successful healing and recovery.

  • Immediate Post-Surgery Care:
    • Pain Management: Patients are prescribed medications to manage discomfort following surgery. Icing the wrist and keeping it elevated can also help reduce swelling.
    • Wound Care: The incision site should be kept clean and dry to prevent infection. Patients will receive detailed instructions on wound care, as well as when to return for a follow-up visit to have stitches removed.
  • Rehabilitation and Occupational Therapy:
    • Phase 1 – Immobilization: After surgery, the thumb and wrist may be immobilized in a splint to allow the tendons to heal.
    • Phase 2 – Gentle Mobilization: Once healing has progressed, gentle exercises will be introduced to restore range of motion and avoid stiffness in the wrist and thumb.
    • Phase 3 – Strengthening: Gradual strengthening exercises will be added to rebuild muscle support around the thumb and wrist, helping you return to your daily activities and sports.
  • Expected Timeline for Recovery: Most patients can expect to resume light activities within two weeks after surgery, with full recovery achieved within a few months depending on the severity of the condition and patient specific goals.

Benefits of Seeking Treatment at HandSport Surgery Institute

Choosing the hand surgeon for your De Quervain Syndrome treatment is essential to ensure the best outcomes. At HandSport Surgery Institute, Drs. Mark and Jason Pruzansky offer world-class care for hand and wrist conditions:

  • Expertise of Drs. Mark and Jason Pruzansky: With years of experience in treating De Quervain Syndrome, Drs. Pruzansky provide comprehensive care using both conservative and surgical approaches. Their expertise ensures that each patient receives the best possible care and personalized treatment plans.
  • Personalized Treatment Plans: At HSSI, every patient receives an individualized treatment plan based on the severity of their condition, lifestyle, and recovery goals. This tailored approach ensures the most effective care.
  • Convenient Location in NYC: Located in New York City, HSSI is easily accessible to residents throughout Manhattan and the surrounding areas, offering expert hand care close to home.

When to Seek Treatment

If you’re experiencing any of the following symptoms, it’s important to seek evaluation for possible De Quervain Syndrome:

  • Persistent Wrist and Thumb Pain: Pain along the thumb side of the wrist that doesn’t improve with rest or over-the-counter medications.
  • Swelling and Stiffness: Ongoing swelling, stiffness, or tenderness in the wrist and thumb that limits your ability to perform daily tasks.
  • Difficulty Gripping or Pinching: Difficulty gripping, pinching, or lifting objects, which may indicate tendon inflammation.

Seeking treatment early can help prevent further damage and lead to a quicker recovery.

Conclusion and Call to Action

De Quervain Syndrome can cause significant discomfort and limit your ability to perform everyday tasks, but with the right treatment, you can maximize recovery. At HandSport Surgery Institute, Drs. Mark and Jason Pruzansky provide expert care tailored to your specific needs. Call 212-249-8700 or use our online scheduling form to book your consultation today and take the first step toward healing.