DeQuervain's Syndrome

DeQuervain's Syndrome: Non-Surgical Treatment in Palm Beach

DeQuervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist, where the abductor pollicis longus and extensor pollicis brevis tendons pass through a tight fibrous sheath. It causes pain and swelling at the base of the thumb and wrist, and is particularly common in new parents from repetitive lifting and in athletes involved in racket sports and golf.

Precise ultrasound-guided injection into the tendon sheath at Palm Beach Regenerative offers an effective, targeted approach for this common wrist condition. For more information, feel free to contact our practice.

What Is DeQuervain's Syndrome?

The first dorsal compartment of the wrist contains two thumb tendons that pass through a fibrous tunnel. When this tunnel becomes thickened and inflamed, or when the tendons swell within it, movement of the thumb causes pain and crepitus at the radial wrist.

Signs and Symptoms

• Pain and swelling on the thumb side of the wrist
• Pain worsening with thumb and wrist movement
• A positive Finkelstein's test: pain with the thumb tucked into the fist and the wrist bent toward the small finger
• Tenderness directly over the first dorsal compartment
• Crepitus with thumb movement in some cases

Common Causes and Risk Factors

• Repetitive thumb and wrist pinching or gripping
• New parent lifting of infants (often called 'mommy wrist')
• Racket sports and golf
• Pregnancy and postpartum hormonal changes affecting tendon inflammation

How It Is Diagnosed

The Finkelstein's test and clinical examination are usually sufficient for diagnosis. Diagnostic ultrasound confirms tendon sheath thickening and allows precise sheath injection targeting.

Dr. Ghattas uses real-time ultrasound to confirm the needle is within the tendon sheath before injection, which is critical for treatment accuracy.

Conventional Treatment Options

• Thumb spica splinting to rest the tendons
• Anti-inflammatory medications
• Corticosteroid injection into the first dorsal compartment: Highly effective when accurately placed in the sheath
• Surgical sheath release for refractory cases

The Palm Beach Regenerative Approach

Dr. Ghattas uses real-time ultrasound guidance to deliver targeted injection precisely within the first dorsal compartment tendon sheath. Rather than or in addition to steroid, concentrated platelet preparation addresses the underlying tendon and sheath inflammation, supporting the body's natural recovery.

Accurate sheath placement under ultrasound guidance produces significantly better outcomes than blind injection, which has a high rate of peritendinous misplacement.

The BioMod Advantage: MLS Robotic Laser Therapy applied to the radial wrist reduces tendon sheath inflammation and supports tendon recovery in DeQuervain's syndrome. Xymogen anti-inflammatory protocols reduce the systemic inflammatory burden contributing to tendon sheath irritation.

Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery or other interventions may be more appropriate.