The problem is a swelling of the tendon sheath around the tendons passing
along the distal radial aspect of the wrist. This sheath runs through a
tight tunnel holding the tendon down to bone and this swollen sheath passing
through a tight tunnel results in significant pain. For this problem there
are three modes of treatment, not treatment, conservative treatment and
surgery.
As a last resort,
when conservative treatment has failed, surgical decompression of the
tendon by opening up the pulley can be performed as an outpatient procedure
under local anesthesia with a small incision. This has a good success
rate.
Conservative treatment
consists of modification of activities, use of a thumb brace and occasional
icing and then possible use of anti-inflammatory medications. If the pain
still persists despite the above treatment a cortisone injection can be
helpful. No more than three cortisone injections are recommended per year
in any one location.
