Recovering from De Quervain’s Tenosynovitis Surgery

The purpose of surgery for De Quervain’s tenosynovitis is to open the compartment that encases the inflamed tendons, so they can move freely without causing pain. The surgery is common and highly successful—those who undergo it can boost their chances for success even more by following these instructions and care tips during recovery.

See De Quervain’s Tenosynovitis

Self-Care Measures After Surgery

Once patients are back home after De Quervain’s tenosynovitis and the local anesthesia begins to wear off, they will notice pain and swelling in the thumb and wrist, and possibly also numbness and tingling at the incision site.

There are several measures patients can take to alleviate pain and swelling as healing begins:

• Keeping the affected hand immobile and elevated whenever possible for the first 2 or 3 days. When sitting or lying down, the hand and wrist can be propped up on a pillow.
• Using ice therapy every 1 to 2 hours during daytime for the first 3 days. Sessions should last no more than 10 to 15 minutes.
• Avoiding use of the hand or wrist for activities that could strain the surgical site for 1 to 2 weeks, including lifting anything heavier than 1 kilogram, typing, doing household chores, or cooking. Most patients will wear a hand and wrist splint for the first 2 weeks.
• Taking pain medications as directed. Patients may receive a short-term prescription for an opioid (narcotic) pain reliever, which carries risks for side effects and dependency and needs to be taken only as directed. Once they are no longer using the opioid, patients can switch to over-the-counter options such as non-steroid anti-inflammatory drugs (NSAIDs), including ibuprofen or naproxen.

See The P.R.I.C.E. Protocol Principles

Patients will need to keep the incision site clean and dry until the physician removes the stitches 1 to 2 weeks after the procedure.

Timeline for Recovery Milestones

Patients can begin to do some gentle range of motion movements and exercises to keep the hand flexible within a few days of surgery. After the stitches are removed, patients may be referred for 6 to 8 weeks of physical therapy to learn stretches and exercises that can restore range of motion, dexterity, and strength for the hand and fingers. Therapists can also teach patients safe ergonomics for avoiding future issues.

Most individuals who undergo this procedure will be able to drive again as soon as they are no longer taking opioid medications. Clearance for returning to work is much more variable, depending on the nature of the job and whether the patient’s dominant hand was affected—time off work may be anywhere from a few days to several weeks.

Typically, patients’ symptoms begin improving immediately after surgery and most experience free movement of wrist and thumb without pain after 6 to 12 weeks.

Potential Risks and Complications

Complications are rare, but all surgery involves some potential risks and complications. The potential complications for this procedure include:

• Infection at the incision site
• Damage to the radial nerve (neuroma), though this is usually temporary
• Tenderness on the incision site
• Displacement of the tendons, causing a snapping or catching sensation in the wrist (very rare)

Patients can decrease their risk for complications by following their post-surgical care instructions.

Medical attention is needed if any of the following symptoms occur:

• Tingling or numbness in hands or fingers
• Significant bleeding from the incision or the incision opening
• Inability to move fingers
• Signs of an infection, which include:
• Pus from the incision
• Skin around incision is swollen or warm to the touch
• A fever

Nearly all those who undergo surgery for De Quervain’s tenosynovitis have a complete recovery from pain and symptoms within a few weeks. For the few who experience complications, they are almost always minor and temporary.

See Symptoms and Risk Factors for De Quervain’s Tenosynovitis