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The pathology is identical in de Quervain seen in new mothers. 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).Įvaluation of histopathological specimens shows a thickening and myxoid degeneration consistent with a chronic degenerative process, as opposed to inflammation. These two muscles run side by side and function to bring the thumb away from the hand the extensor pollicis brevis brings the thumb outwards radially, and the abductor pollicis longus brings the thumb forward away from the palm. The two tendons concerned are those of the extensor pollicis brevis and abductor pollicis longus muscles. The mucous sheaths of the tendons on the back of the wrist.ĭe Quervain syndrome involves noninflammatory thickening of the tendons and the synovial sheaths that the tendons run through. Contributory factors may include increased housework, hormonal changes, fluid retention and-more debatably-lifting.
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The syndrome commonly occurs during and after pregnancy. Specific activities that have been postulated as potential risk factors include intensive computer mouse use, trackball use, and typing, as well as some pastimes, including bowling, golf, fly-fishing, piano-playing, sewing, and knitting. These movements are associated with many types of repetitive housework such as chopping vegetables, stirring and scrubbing pots, vacuuming, cleaning surfaces, drying dishes, pegging out washing, mending clothes, gardening, harvesting and weeding. Workers who perform rapid repetitive activities involving pinching, grasping, pulling or pushing have been considered at increased risk. Proponents of the view that De Quervain syndrome is a repetitive strain injury consider postures where the thumb is held in abduction and extension to be predisposing factors. However, researchers in France found personal and work-related factors were associated with de Quervain's disease in the working population wrist bending and movements associated with the twisting or driving of screws were the most significant of the work-related factors. A systematic review of potential risk factors discussed in the literature did not find any evidence of a causal relationship with occupational factors. Evidence regarding a possible relation with occupational risk factors is debated.
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The cause of de Quervain's disease is not established. Young people using their smartphones with their thumbs. It was first described in 1895 by Fritz de Quervain. Those who are middle aged are most often affected. The condition affects about 0.5% of males and 1.3% of females. If this is not effective steroid injections or surgery may be recommended. Treatment involves avoiding activities that bring on the symptoms, pain medications such as NSAIDs, and splinting the thumb. Diagnosis is supported if pain increases when the wrist is bent inwards while a person is grabbing their thumb within a fist. The diagnosis is generally based on symptoms and physical examination. Risk factors include certain repetitive movements, trauma, and rheumatic diseases. For this reason, it's better not to blame activity without strong scientific support. Humans tend to misinterpret painful activities as causing the problem to get worse and this misinterpretation is associated with greater pain intensity. There is speculation that the problem is related to use of the hand, but this is not supported by experimental evidence. Symptoms can come on gradually or be noted suddenly. On occasion, there is uneven movement or triggering the thumb with radial abduction. Radial abduction of the thumb is painful. This results in pain and tenderness on the thumb side of the wrist. Repetitive movements, trauma, rheumatic diseases Īvoiding activities that bring on the symptoms, pain medications, splinting the thumb ĭe Quervain syndrome is mucoid degeneration of two tendons that control movement of the thumb and their tendon sheath. Hand surgery, Plastic surgery, Orthopedic surgery.