treatment

Last reviewed 01/2018

If De Quervain's disease is diagnosed early in its course then conservative therapy with avoidance and modification of exacerbating movements plus thumb splints may be all that is required.

• management:
  • involves avoidance and modification of exacerbating thumb and wrist movements
    • thumb splints (spicas) can provide immediate relief
      • essential when prescribing a splint to make sure it is a specific thumb splint rather than a wrist splint that does not immobilise the thumb
      • to avoid confusion it is best to prescribe a 'thumb spica' rather than a splint.
    • in resistant cases a corticosteroid injection into the tendon sheath is often very effective. Resistant cases can be referred for ultrasound-guided injections or surgical decompression
      • ifthe condition is chronic then an operation may be required which involves slitting the thickened lateral wall of the tendon sheath

Reference:

• (1) Arthritis Research UK (April 2013). The upper limb in primary care. Part 2: Wrist, hand. Hands On 2(7).