Twist and shout

Your nagging wrist pain is interfering with simple activities. Normal everyday movements you previously took for granted – pinching, gripping, twisting – are now very painful.

Daniel Osei, MD, hand and wrist orthopedic specialist explains, “Pain on the radial, or thumb side, of the wrist, is commonly caused by inflammation along the tendons extending from the forearm and wrist into the base of the thumb, and is known as de Quervain’s tendonitis.”

De Quervain’s tendonitis typically affects women and develops slowly, oftentimes with the onset of a new activity, such as holding a baby, gardening for the first time in the spring, or even a different exercise routine.

Patients notice pain on the thumb side of the wrist that may radiate up the arm towards the elbow. They may also notice some swelling in the area of maximum tenderness.

Initial treatment includes rest and temporarily refraining from activities that worsen symptoms. Taking non-steroidal anti-inflammatory medications and wearing a splint to prevent excessive thumb motion may also be helpful in the first stages of treatment.

If pain persists, a steroid injection into the affected area may help quiet the inflammation and decrease pain. Non-surgical therapy works for approximately 90% of patients, but for those whose symptoms are not relieved, surgery is the next option.

The outpatient surgical procedure involves a small incision over the affected area to release the two tendons (abductor pollicis longus and extensor pollicis brevis) from the tunnel in which they are being irritated. Surgery has a high success rate, with 90-95% of patients experiencing pain relief and the ability to resume all activities.

“Prevention is always the best cure”, adds Dr. Osei. “Early non-operative treatment including rest and immobilization often leads to resolution of symptoms in four to six weeks. However, if symptoms last longer, it’s time to make an appointment to see your doctor.”

If you have chronic wrist/hand pain and would like to make an appointment with Dr. Osei, he sees patients at two convenient locations:

Center for Advanced Medicine
Orthopedic Surgery Center
4921 Parkview Place, 6th floor, Suite A

Washington University Orthopedics
14532 South Outer Forty Drive

Please call 314-514-3500 to make an appointment.