×

JOIN OUR NEWSLETTER TO UNLOCK 20% OFF YOUR FIRST PURCHASE.

Company name
Sign up

Existing customer? Sign in

De Quervain Disease

Disease Details

Family Health Simplified

Buy Membership
Description
De Quervain disease is a painful condition affecting the tendons on the thumb side of your wrist, often due to repetitive hand or wrist movements.
Type
De Quervain disease is a type of tenosynovitis, which is an inflammation of the sheath or tunnel that surrounds two tendons that control movement of the thumb. It is not typically associated with genetic transmission, as it is mainly caused by repetitive motion or overuse of the wrist and thumb.
Signs And Symptoms
Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. The onset is often gradual, but sometimes the symptoms seem to come on suddenly and the problem is often misinterpreted as an injury.
Prognosis
The prognosis for De Quervain's disease, also known as De Quervain's tenosynovitis, is generally good. With appropriate treatment, including rest, splinting, anti-inflammatory medications, physical therapy, and, in some cases, corticosteroid injections, most individuals experience significant relief. For those who do not respond to conservative treatments, a minor surgical procedure to release the constricted tendon sheath can also be effective. Overall, most patients can expect a full recovery with proper management.
Onset
Onset of De Quervain's disease (De Quervain's tenosynovitis) generally occurs gradually. It is often associated with repetitive hand or wrist movements, but can also develop suddenly if there is a specific injury or overuse of the wrist. Symptoms typically include pain and swelling near the base of the thumb.
Prevalence
The prevalence of De Quervain's disease, also known as De Quervain's tenosynovitis, varies, but studies suggest it affects approximately 0.5% of men and 1.3% of women. It is more commonly observed in individuals aged 30 to 50 and is particularly prevalent among mothers of young children and people who engage in repetitive wrist and thumb movements.
Epidemiology
De Quervain's disease, also known as De Quervain's tenosynovitis, affects the tendons on the thumb side of your wrist. Here is a brief overview of its epidemiology:

- **Prevalence**: Estimates suggest a prevalence of approximately 0.5% in men and 1.3% in women.
- **Age**: Most commonly diagnosed between the ages of 30 and 50.
- **Gender**: Women are about 3 to 10 times more likely to develop this condition compared to men, possibly due to hormonal differences and activity patterns.
- **Risk Factors**: Activities that require repetitive hand or wrist movements, such as certain sports or occupations, can increase the risk. Postpartum women and those caring for infants are also at a higher risk due to repetitive lifting.

Understanding the epidemiology helps in identifying populations at risk and tailoring preventive and therapeutic strategies accordingly.
Intractability
De Quervain's disease, also known as De Quervain's tenosynovitis, is not generally considered intractable. It is often manageable with conservative treatments such as rest, splinting, anti-inflammatory medications, and physical therapy. In more severe or persistent cases, corticosteroid injections or surgical intervention may be required. Most individuals experience significant relief with appropriate treatment.
Disease Severity
De Quervain disease, also known as De Quervain's tenosynovitis, is a condition that affects the tendons on the thumb side of the wrist, causing pain and swelling.

Disease Severity: The severity of De Quervain's disease can range from mild to severe, depending on the inflammation and the body's response to treatment. In mild cases, individuals may experience discomfort that can be managed with rest or non-steroidal anti-inflammatory drugs (NSAIDs). Severe cases may significantly impair wrist and thumb function, sometimes requiring corticosteroid injections or even surgical intervention to relieve symptoms.
Healthcare Professionals
Disease Ontology ID - DOID:14107
Pathophysiology
De Quervain syndrome involves noninflammatory thickening of the tendons and the synovial sheaths that the tendons run through. The two tendons concerned are those of the extensor pollicis brevis and abductor pollicis longus muscles. These two muscles run side by side and function to bring the thumb away from the hand (radial abduction). De Quervain tendinopathy affects the tendons of these muscles as they pass from the forearm into the hand via a fibro-osseous tunnel (the first dorsal compartment).
Evaluation of histopathological specimens shows a thickening and myxoid degeneration consistent with a chronic degenerative process, as opposed to inflammation or injury. The pathology is identical in de Quervain syndrome cases seen in new mothers.
Carrier Status
De Quervain's disease, also known as De Quervain's tenosynovitis, is not a genetic disorder; therefore, there are no "carriers" for this condition. It is an inflammation of the tendons on the thumb side of the wrist, typically caused by overuse or repetitive motions.
Mechanism
De Quervain disease, also known as De Quervain tenosynovitis, is a condition affecting the tendons on the thumb side of the wrist.

### Mechanism:
The primary mechanism involves the inflammation of the sheath (synovium) surrounding the two tendons responsible for moving the thumb (abductor pollicis longus and extensor pollicis brevis). This leads to swelling, pain, and restricted movement.

### Molecular Mechanisms:
The exact molecular mechanisms underlying De Quervain disease are not entirely understood. However, it is believed to involve:

1. **Inflammatory Cytokines**: Overproduction of pro-inflammatory cytokines (e.g., TNF-alpha, IL-1, IL-6) within the tendon sheath can contribute to inflammation and pain.
2. **Matrix Metalloproteinases (MMPs)**: These enzymes can degrade extracellular matrix components, potentially leading to tendon degeneration and increased tissue swelling.
3. **Fibrosis**: Chronic inflammation can lead to fibroblast activation and subsequent fibrosis within the tendon sheath, further constricting the tendons and exacerbating symptoms.

Collectively, these molecular changes contribute to the clinical presentation of pain, swelling, and limitation in thumb and wrist movement characteristic of De Quervain disease.
Treatment
Most tendinoses and enthesopathies are self-limiting and the same is likely to be true of de Quervain syndrome, although further study is needed.The mainstay of symptom alleviation (palliative treatment) is a splint that immobilizes the wrist and the thumb to the interphalangeal joint. Activities are more comfortable with such a splint in place. Anti-inflammatory medication or acetaminophen may also alleviate symptoms.As with many musculoskeletal conditions, the management of de Quervain disease is determined more by convention than scientific data. A systematic review and meta-analysis published in 2013 found that corticosteroid injection seems to be an effective form of conservative management of de Quervain syndrome in approximately 50% of patients, although they have not been well tested against placebo injection. Consequently, it remains uncertain whether injections are palliative and whether they can alter the natural history of the illness. One of the most common causes of corticosteroid injection failure is the presence of subcompartments of the extensor pollicis brevis tendon.Surgery (in which the sheath of the first dorsal compartment is opened longitudinally) is documented to provide relief in most patients. The most important risk is to the radial sensory nerve. A small incision is made and the dorsal extensor retinaculum is identified. Once it has been identified, the release is performed longitudinally along the tendon. This is done to prevent potential subluxation of the first compartment tendons. Next, the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) are identified, and the compartments are released.Some occupational and physical therapists suggest alternative lifting mechanics based on the theory that the condition is due to repetitive use of the thumbs during lifting. In addition, physical/occupational therapists can suggest activities to avoid (based on the theory that certain activities might exacerbate the condition) and can introduce strengthening exercises (based on the theory that this will contribute to better form and promote the use of other muscle groups, which might limit irritation of the tendons).Some occupational and physical therapists use other treatments in conjunction with therapeutic exercises, based on the rationale that they reduce pain and promote healing: ultrasound, short-wave diathermy, or other deep heat treatments, as well as TENS, acupuncture, infrared light therapy, and cold laser treatments.
Compassionate Use Treatment
De Quervain disease, also known as De Quervain's tenosynovitis, primarily affects the tendons in the thumb. Compassionate use treatments, off-label, or experimental treatments for this condition might include:

1. **Compassionate Use Treatments**:
- In severe cases where conventional treatments have failed, procedures like ultrasound-guided tendon sheath injections or minimally invasive surgery might be considered under compassionate use terms.

2. **Off-Label Treatments**:
- **Botulinum Toxin Injections**: Though not officially approved for De Quervain disease, botulinum toxin A injections have been explored for their pain-relief and anti-inflammatory properties.
- **Platelet-Rich Plasma (PRP) Therapy**: This involves injecting a concentration of the patient's own platelets to accelerate healing of injured tendons, potentially offering relief.

3. **Experimental Treatments**:
- **Stem Cell Therapy**: Investigations are ongoing into the application of stem cell therapy for tendon repair and regeneration.
- **Gene Therapy**: Experimental research is looking into gene therapy as a means to treat chronic tendon injuries and inflammation.

These treatments should only be considered in consultation with healthcare professionals, as they carry varying degrees of risk and efficacy.
Lifestyle Recommendations
For De Quervain's disease, lifestyle recommendations include:

1. **Rest the Affected Thumb and Wrist**: Avoid activities that cause pain, particularly repetitive hand movements.
2. **Thumb Splint**: Use a thumb splint to immobilize the thumb and wrist, providing rest to the tendons.
3. **Ergonomic Adjustments**: Modify tasks and adapt tools to reduce strain on the thumb and wrist.
4. **Anti-inflammatory Measures**: Apply ice to the affected area to reduce swelling and inflammation.
5. **Exercises**: Gentle stretching and strengthening exercises, as recommended by a physical therapist, can help improve function and prevent recurrence.
6. **Healthy Diet**: Maintain a well-balanced diet to support overall joint health.
7. **Stress Management**: Practice stress-relief techniques, such as yoga or meditation, to reduce muscle tension.

Following these recommendations can help manage symptoms and prevent the condition from worsening.
Medication
De Quervain's disease, also known as De Quervain's tenosynovitis, involves inflammation of the tendons in the thumb. For treatment, the following medications are often recommended:

1. **Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):** These help reduce pain and inflammation. Common options include ibuprofen and naproxen.
2. **Corticosteroid Injections:** An injection of corticosteroids into the tendon sheath can help reduce inflammation and pain.

Consulting a healthcare professional for a tailored treatment plan is important.
Repurposable Drugs
De Quervain's disease, also known as De Quervain's tenosynovitis, is an inflammation of the tendons located on the thumb side of the wrist. Treatment often involves nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for pain management. Corticosteroid injections can also be utilized for their anti-inflammatory effects.

Regarding repurposable drugs, certain medications used for other inflammatory conditions might be repurposed for De Quervain's disease, such as methotrexate (typically used for rheumatoid arthritis), although this is not commonly practiced and requires clinical consideration.

More experimental treatments might involve biologic agents like TNF inhibitors, but such approaches are still under research and not standard practice. Always consult a healthcare professional before starting any treatment.
Metabolites
De Quervain's disease, or De Quervain's tenosynovitis, is a condition that affects the tendons on the thumb side of your wrist. Information specific to metabolites associated with De Quervain's disease is minimal as it is primarily a mechanical or inflammatory condition rather than a metabolic disease. The condition generally involves inflammation of the sheaths of the tendons.
Nutraceuticals
There are no widely recognized nutraceuticals specifically recommended for De Quervain's disease. Management typically involves rest, splinting, NSAIDs, and corticosteroid injections. Always consult a healthcare provider for appropriate treatment options.
Peptides
Peptides and nanoparticles (nan) are emerging areas of research in the treatment of De Quervain's disease, though there is limited evidence on their clinical application for this specific condition. Current treatments typically involve rest, splinting, NSAIDs, corticosteroid injections, or surgery. Further studies are needed to confirm the effectiveness of peptides and nanotechnology-based therapies in managing De Quervain's disease.