DeQuervain's Release

De Quervain’s release is a surgical procedure designed to relieve pain from De Quervain’s tenosynovitis, a condition that affects the tendons in the wrist. When conservative treatments fail, surgery becomes necessary to reduce pain and improve function.

If you’re struggling with wrist pain, Orthopaedic Associates of Zanesville offers specialized care for hand and wrist conditions. Contact our office in Zanesville, Ohio, today to schedule an appointment!

What is De Quervain's Tenosynovitis?

De Quervain’s tenosynovitis is a painful inflammation of the tendons on the thumb side of the wrist. The tendons affected are responsible for thumb extension and abduction, making wrist movements difficult and painful. This condition is often caused by repetitive motions or overuse of the wrist and thumb, which can lead to tendon irritation and swelling.

While the exact cause isn’t always clear, certain risk factors, such as repetitive tasks like gardening or lifting a child, can contribute to the development of De Quervain’s tenosynovitis. Trauma to the wrist or inflammatory conditions such as rheumatoid arthritis can also increase the likelihood of developing the condition.

Symptoms of De Quervain's Tenosynovitis

The primary symptom of De Quervain’s tenosynovitis is pain on the thumb side of the wrist, which may worsen with movements like gripping, pinching, or rotating the wrist. Other common symptoms include:

Swelling near the base of the thumb
Pain that may radiate into the forearm
A sensation of catching or snapping during thumb movement
Tenderness or visible swelling around the base of the thumb

Causes of De Quervain's Tenosynovitis

Causes of De Quervain’s tenosynovitis typically involve repetitive strain on the wrist. Activities that require frequent gripping, such as sports, lifting, or even typing, can aggravate the tendons. Certain groups, such as new mothers, are particularly prone to this condition due to the repetitive lifting of infants.

Treatment Options for De Quervain's Tenosynovitis

De Quervain tendinitis treatment usually starts with conservative, non-surgical approaches to reduce swelling and relieve pain. Common treatment methods include:

Rest and immobilization: Wearing a splint to immobilize the thumb and wrist can reduce inflammation and allow the tendons to heal.
Pain medicine: Over-the-counter NSAIDs, such as ibuprofen, help relieve pain and reduce swelling.
Corticosteroid injections: These can effectively reduce inflammation around the affected tendons, often providing quick relief.
Occupational therapy: Working with an occupational therapist can help improve strength, flexibility, and mobility in the wrist.

If these non-invasive methods do not provide sufficient relief, De Quervain’s release surgery may be recommended.

How to Prepare for De Quervain's Release Surgery

Before undergoing De Quervain’s release surgery, your doctor will evaluate your condition and determine whether surgery is the best option for you. Here’s how you can prepare:

Consultation: During your consultation, your doctor will review your medical history, perform a physical exam, and may order imaging tests to confirm the diagnosis and rule out other conditions.
Pre-surgical instructions: Your doctor will provide detailed instructions, including which medications to avoid. If you’re taking pain medication, your doctor may recommend adjusting the dosage before the procedure. You may be advised to avoid eating or drinking after midnight on the day of the surgery.
Transportation: Since this is an outpatient procedure, make sure to arrange for someone to drive you home after the surgery.

The De Quervain's Release Procedure

De Quervain’s release procedure is typically quick and lasts less than an hour. It’s performed on an outpatient basis, meaning you can go home the same day. Here’s an outline of the process:

Anesthesia: Local anesthesia is commonly used to numb the wrist area, though general anesthesia may be an option for some patients.
Small incision: The surgeon makes a small incision along the thumb side of the wrist to access the inflamed tendons.
Tendon sheath release: The sheath around the affected tendons is carefully cut to relieve pressure and allow the tendons to move freely.
Closing the incision: The incision is closed with sutures, and a bandage is applied to protect the area.

What to Expect After De Quervain's Release Surgery

After the surgery, your wrist will be bandaged, and you may experience mild discomfort, which can be managed with pain medicine prescribed by your doctor. It’s important to follow all post-operative care instructions to ensure the area heals completely.

Recovery Timeline

First few days: In the first few days following surgery, you’ll need to rest your hand and avoid strenuous activities. Your doctor will likely recommend icing the area and keeping your wrist elevated to reduce swelling.
1 to 2 weeks: During your follow-up visit, your doctor will remove the sutures. At this point, you may be advised to start gentle wrist exercises to regain mobility.
4 to 6 weeks: Most patients can return to their normal activities after 4 to 6 weeks, depending on how quickly the wrist heals. With proper care, your wrist should heal completely, allowing you to resume your daily routine without pain or discomfort. Physical or occupational therapy may be prescribed to help strengthen the wrist and restore the full range of motion.

Tips for a Smooth Recovery

Follow your doctor’s instructions: Be diligent about keeping your follow-up appointments and follow your doctor’s guidelines to ensure proper healing.
Keep the wrist elevated: Elevating the wrist and applying ice can help reduce swelling and discomfort.
Maintain a normal diet: Eating a balanced diet helps support healing and provides the nutrients your body needs.

Orthopaedic Associates of Zanesville: Expert Care for De Quervain's Tenosynovitis

At Orthopaedic Associates of Zanesville, we specialize in diagnosing and treating hand, wrist, and elbow conditions like De Quervain’s tenosynovitis. Our expert team in Zanesville, Ohio, is dedicated to helping patients relieve pain and regain function.

If you’re experiencing wrist pain or have been diagnosed with De Quervain’s tenosynovitis, visit our wrist specialty page to learn more about treatment options and how we can help you get back to your daily life pain-free.

Medically reviewed by Benjamin R. Pulley, MD, FAAOS

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Sources

https://orthoinfo.aaos.org/en/diseases–conditions/de-quervains-tendinosis/