What is De Quervain’s tenosynovitis (washerwoman’s sprain)

De Quervain’s tenosynovitis or washerwoman’s sprain, is a painful wrist condition involving two of the tendons at the wrist – the thumb extensors called Extensor pollicus brevis and abductor pollicus longus at the base of the thumb.

De Quervain's tenosynovitis - washerwoman's sprain

Statistics on De Quervain’s tenosynovitis (washerwoman’s sprain)

This condition is usually seen in patients age 40-50 typically, though patients of other ages may be affected.

Risk Factors for De Quervain’s tenosynovitis (washerwoman’s sprain)

Despite the name (washerwoman’s sprain) – the condition is seen in men as well as women, and can occur with any profession/activity involving rapid, repetitive movements of the thumb and wrist – eg wringing clothes, assembly line workers.

Progression of De Quervain’s tenosynovitis (washerwoman’s sprain)

  • There may be a gradual onset of a dull ache, or an acute flare-up.
  • The pain is worse with activities such as turning on taps, turning door handles, lifting teapots – anything requiring grasping.
  • The pain often subsides with time if the person abstains from the activity.

    How is De Quervain’s tenosynovitis (washerwoman’s sprain) Diagnosed?

    No investigations are necessary.

    Prognosis of De Quervain’s tenosynovitis (washerwoman’s sprain)

    This is not a serious condition, though it can be reasonably disabling in the sense that it limits the use of the hand – writing, performing occupational activities. It usually lasts for months – though this depends on treatment and whether the exacerbating activity is stopped.

    How is De Quervain’s tenosynovitis (washerwoman’s sprain) Treated?

  • Rest, with avoidance of the causative stress on the thumb abductor and extensors.
  • A splint can be used – one that immobilises the wrist, and also involves the thumb.
  • Corticosteroid injections into the tendon sheath can help.
  • Surgical release may be required in chronic cases.

    De Quervain’s tenosynovitis (washerwoman’s sprain) References

  • Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002.
  • Moore, KL, Clinically orientated anatomy 3rd ed; Williams and Wilkins, 1992.
  • Murtagh, J. General Practice. Second Ed. McGraw-Hill, 1998.