De Quervain's Syndrome or stenosing tenosynovitis of the first compartment of the extensor muscles of the hand.

This syndrome is relatively common in the population and occurs more frequently in middle-aged women. It is a clinical entity described as the narrowing of the sheath of two tendons: the abductor pollicis longus and the extensor pollicis brevis.

A tendon sheath is defined as a structure made of fibrous tissue that surrounds the tendon, protecting it from wear and simultaneously reducing frictional forces during the tendon’s movement in the contraction and relaxation of the muscle to which the tendon belongs.

The most common cause of this condition is chronic use/overuse of the wrist in work, daily habits, etc. It is often seen in mothers who repeatedly lift their children or in individuals whose work is manual and requires repetitive wrist movements.

People who most commonly experience this syndrome include primarily women over forty years old, pregnant individuals (due to hormonal factors), patients with certain rheumatic conditions, and those who have previously injured their wrist.

The most common symptoms include pain over the base of the thumb, which may "radiate" along the forearm from the side of the thumb, a feeling of numbness in the area of the thumb and index finger, a sensation of catching in the free movement of the involved tendons, and a feeling of creaking (grating) during thumb movement.

The diagnosis of the syndrome is made clinically by the orthopedic surgeon, who is tasked with assessing its presence and determining if there is any other condition that may be causing similar symptoms.

The treatment includes a range of options. Conservative management begins with medication, the use of special immobilization splints, and modifications to daily habits that cause or exacerbate the symptoms.

In more advanced cases, there is the option of using injectable local anesthetics and/or corticosteroids in the area of the sheath.

In any case, the involvement of a physical therapist is considered beneficial, always under the guidance of the orthopedic surgeon.

Surgical treatment of the syndrome is considered the final solution when conservative treatment has failed or when the patient presents with a significantly advanced syndrome that no longer benefits from conservative management efforts.

Surgical treatment involves a small incision in the area of the problematic sheath and decompression of the involved tendons. Postoperatively, the patient takes care of the wound until the sutures are removed, while physical therapy may be needed until the freed tendons regain full function.