Section 5. Bone, Joint, and Muscle Disorders

Chapter 74. Disorders of Muscles, Bursas, and Tendons

Topics: Introduction | Muscle Cramps | Fibromyalgia | Bursitis | Tendinitis and Tenosynovitis | De Quervain's Syndrome | Baker's Cysts

De Quervain's Syndrome

De Quervain's syndrome (also called washerwoman's sprain) is swelling and inflammation of the tendons or tendon sheaths that move the thumb outward.

This disorder usually occurs after repetitive use of the wrist. The main symptom is aching pain on the thumb side of the wrist and at the base of the thumb, which becomes worse with movement. The area at the base of the thumb at the wrist is also tender.

To diagnose the disorder, a doctor performs a Finkelstein test. The person bends the affected thumb into the palm and wraps the fingers over the thumb. With the palm facing up, the doctor rotates the palm toward the middle of the body. If this movement causes pain, the test is positive for de Quervain's syndrome.

Rest, warm soaks, and nonsteroidal anti-inflammatory drugs (NSAIDs) are effective only for very mild cases. Injections of corticosteroids into the tendon sheath are helpful in 80 to 90% of cases; surgery is needed occasionally.