Hand Pain: Is It Tendonitis, De Quervain's, or Carpal Tunnel Syndrome?

Tendinitis?

I have been experiencing pain in the back of my hand for two to three years.
Initially, it started during the summer when I worked over 12 hours a day doing packaging work.
Now, I sometimes experience swelling, warmth, and pain (the pain is indescribable; even when my hand is at rest, it still hurts, and even simple tasks like unlocking a door can be painful).
Is this tendonitis, or is it "mom's hand" (de Quervain's tenosynovitis), fasciitis, or carpal tunnel syndrome? Additionally, how can I effectively treat it? I would like to recover as soon as possible.
Thank you!

Judy, 20~29 year old female. Ask Date: 2008/09/02

Dr. Pan Yingda reply Rehabilitation

It should be tendinitis! (Conditions like "mom's thumb," tennis elbow, and golfer's elbow are all types of tendinitis, just in different locations.) However, there’s no reason for it to persist for two to three years! Regarding tendinitis, you shouldn't overuse it, but you also shouldn't completely avoid movement.
In the outpatient clinic, most patients are hesitant to move unless their work or profession requires repetitive use, which leads to slower recovery! I haven't seen your condition, so I'm not sure about the current state of your inflammation.
I can't provide further advice; as a young person, you should recover quickly! Since it has already been two to three years, I recommend increasing your activity level and strengthening your hand muscles! If you have any questions, feel free to ask!

Reply Date: 2008/09/02

More Info

Understanding hand pain can be quite complex, especially when considering various conditions such as tendonitis, De Quervain's tenosynovitis, and carpal tunnel syndrome. Based on your description of symptoms—persistent pain, swelling, and heat in the back of your hand, particularly after extensive use during your summer job—it is essential to evaluate the potential causes and appropriate treatment options.

Potential Conditions
1. Tendonitis: This condition occurs when the tendons, which connect muscles to bones, become inflamed. Given your history of repetitive motion during your job, tendonitis is a plausible diagnosis. Symptoms typically include pain and tenderness around the affected tendon, which can worsen with movement.

2. De Quervain's Tenosynovitis: This specific type of tendonitis affects the tendons on the thumb side of your wrist. It is characterized by pain and swelling near the base of the thumb, which can radiate up the forearm. If your pain is localized to the thumb area and worsens with gripping or pinching motions, this may be the condition you are experiencing.

3. Carpal Tunnel Syndrome: This condition arises when the median nerve, which runs through the wrist, becomes compressed. Symptoms often include numbness, tingling, and pain in the thumb, index, middle, and part of the ring finger. While you mentioned pain in the back of your hand, if you also experience any numbness or tingling in these fingers, carpal tunnel syndrome could be a factor.

4. Trigger Finger (or "Mommy's Finger"): This condition occurs when a finger gets stuck in a bent position due to inflammation of the tendons. It can cause pain and a sensation of locking or catching when trying to straighten the finger.

Diagnosis and Treatment
To accurately diagnose your condition, it is crucial to consult a healthcare professional, preferably a hand specialist or an orthopedic surgeon. They may perform a physical examination, review your medical history, and possibly conduct imaging tests (like an ultrasound or MRI) to assess the tendons and nerves in your hand.

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Treatment Options
1. Rest and Activity Modification: Reducing activities that exacerbate your symptoms is vital. Allowing your hand to rest can help decrease inflammation and pain.

2. Ice Therapy: Applying ice to the affected area can help reduce swelling and numb the pain. It is generally recommended to ice the area for 15-20 minutes every few hours.

3. Splinting: Using a splint can immobilize the wrist or fingers, providing support and preventing further irritation of the tendons or nerves.

4. Physical Therapy: A physical therapist can guide you through exercises to strengthen the muscles around the wrist and improve flexibility, which may alleviate symptoms.

5. Medications: Over-the-counter anti-inflammatory medications (like ibuprofen or naproxen) can help reduce pain and swelling. In some cases, a doctor may prescribe corticosteroids to reduce inflammation.

6. Injections: If conservative treatments fail, corticosteroid injections may be considered to reduce inflammation in the affected area.

7. Surgery: In severe cases, particularly with carpal tunnel syndrome or persistent trigger finger, surgical intervention may be necessary to relieve pressure on the nerves or to release the affected tendons.

Conclusion
In summary, your symptoms could be indicative of several conditions, including tendonitis, De Quervain's tenosynovitis, or carpal tunnel syndrome. A thorough evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate treatment plan. Early intervention can significantly improve outcomes and help you return to normal function. Remember, self-diagnosis can often lead to mismanagement, so seeking professional advice is the best course of action.

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