The tendons that straighten the fingers and thumb travel on the back of the wrist, and are held down to the wrist by a series of tunnels, or pulleys. When the tendons that straighten the thumb become swollen and inflamed as they pass through one of the tunnels, it becomes painful to use the thumb. Repeated use of the thumb only causes more swelling and inflammation of these tendons.
Repeated use of the hands and thumb, especially pinching, gripping or squeezing. Gardening, knitting, keyboarding etc.
Pain in the wrist, with use of the thumb.
Tenderness, and occasional swelling along the thumb extensor tendons. A positive Finklestein’s test.
History and physical exam is usually sufficient. Occasionally, x-rays are obtained to rule out other causes of pain, such as arthritis.
Splinting, anti-inflammatory medication, and a trial of a corticosteroid injection into the tendon sheath.
Release of the band, or part of the tunnel that is causing constriction of the tendons.
Non-operative treatment is usually successful. Surgical release is generally curative, and can be performed with local anesthesia, often in an office setting.