A Gamer’s Thumb

Do you know playing golf or racket sports can lead to inflammation of tendons in the wrist and lower thumb? Here’s how it can be treated

Athletes or sports persons often develop a condition called ‘gamer’s thumb.’ In scientific terms, it is known as de Quervain’s tenosynovitis. This refers to a painful inflammation of tendons in the wrist and lower thumb. A person suffering from de Quervain’s tenosynovitis often experiences pain along the back of the thumb, directly over the two tendons. Sometimes, swelling and pain is also experienced at the base of the thumb or in the wrist. This condition occurs when the inflamed and swollen tendons rub against the narrow tunnel through which they pass. As a result, the patient finds it difficult to grasp anything or turn the wrist. Though experts are yet to ascertain the exact cause behind the occurrence of such a condition, it is largely believed that repetitive activities involving movement of the hand or wrist—such as while playing golf or racket sports—can lead to inflammation of the tendons.

Symptoms

A patient suffering from de Quervain tenosynovitis may feel pain near the base of the thumb. In some cases, swelling is also noticed. The patient may face difficulty in moving the thumb and the wrist while performing grasping or pinching actions. While moving the thumb, the patient may also witness ‘sticking’ or ‘stop-and-go’ sensation. In worst cases, there is a chance for the pain to spread farther to the forearm. Movement of the thumb and wrist aggravates the pain.

Causes

De Quervain tenosynovitis is caused due to the inflammation of the two tendons on the thumb side of the wrist. Tendons attach muscles to bone. The inflammation occurs due to overuse or repetitive action involving the affected area (thumb or wrist). The repetitive action can lead to irritation of the covering around the tendons. As a result, the tendons swell up and get thickened leading to restricted movement. Apart from this, it can also be caused due to inflammatory arthritis, such as rheumatoid arthritis, or any direct injury to the wrist or tendon. In some cases, fluid retention due to changes in hormones during pregnancy can also lead to the condition.

Diagnosis

The health care provider will first go for a physical examination of the hand. He or she will try to ascertain if you feel pain, when pressure is applied on the thumb side of the wrist. The patient may be asked to perform a Finkelstein test. In this test, the patient is made to bend his or her thumb across the palm of the hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of the wrist, it is likely that you have de Quervain tenosynovitis.

Treatment

The main aim of the treatment is to reduce inflammation and restore movement of the thumb. The focus is also on prevention of recurrence. Generally, if the treatment is started early, the symptoms should improve in 4 to 6 weeks. To reduce pain and swelling, pain relievers can be recommended. The doctor may also prescribe injections of corticosteroid medications. Surgery is recommended only in serious cases.

Points to remember

• Immobilize the thumb and wrist.
• Keeping them straight with a splint or brace
• Avoid repetitive thumb movements
• Apply ice to the affected area
• Can seek advice of therapist to learn exercises for the wrist, hand and arm, which strengthen the muscles around these areas.