Since the cause of De Quervain's syndrome is often unknown or idiopathic a concrete diagnosis of De Quervain's syndrome may be difficult. However it is quite possible to diagnosis with a reasonable certainty. To aid in diagnosing your De Quervain's syndrome there are some steps you should take to monitor your symptoms and gather your data.
Monitor Your Symptoms
To diagnose your De Quervain's syndrome you should carefully monitor your symptoms. This will help in ruling out other conditions, which is crucial for proper treatment and prevention. It will also help identify the causes. Use a Visual Analog Pain Scale to track your symptoms and their severity. When you notice an aggravation in your De Quervain's syndrome symptoms make sure to identify the activities that preceded it. This will help establish a timeline to define the contributing causes.
Identify the Causes
After monitoring your symptoms for a while you may notice a pattern or some activities that result in an increase in your pain. These are the tasks that are most likely causing or contributing to the repetitive stress behind your De Quervain's syndrome. If you've identified a probable cause for your De Quervain's syndrome you can try removing the activity from your schedule to see if the symptoms abate.
Remove the task from your daily activity, limit the intensity or length of the task, or divide the task into small increments with long breaks in between. Then, see if the symptom persists. If that is not practical, try moving the task to a different time of day, or perform it in a different location. This will help you identify if the symptom is caused by the task itself or the circumstances in which it is performed. This may help identify the cause but it is not a standalone treatment for De Quervain's syndrome.
Various tests can be performed to help narrow down the pain causing culprit. For a diagnosis of De Quervain's syndrome the Finkelstein's test will cause pain. In the Finkelstein's test an up and down fist is made, like when giving a thumbs up, except the thumb is placed inside the fingers and held tightly in the fist. The wrist is then flexed downward to elongate the top of the wrist so that the base of the thumb is in a flat plane with the top of the forearm, as if you were pointing downward with your pointer finger. Pain, sometime severe, will be felt along the thumb side of the wrist, especially right below the wrist on the forearm.
If you feel you are suffering from chronic or severe De Quervain's syndrome your doctor, chiropractor or physical therapist can be consulted for a diiferential diagnosis and to establish a regiment for treating your De Quervain's syndrome.
In diagnosing De Quervain's syndrome other common ailments will most likely be considered as part of a differential diagnosis. The specific location of the pain and hand positions that cause it can help rule out these other conditions and make the diagnosis of De Quervain's syndrome more accurate. Other considered conditions include:
- Thumb sprain
- Stress fracture
- Intersection syndrome
- Tendinitis of the hand/wrist
- Bursitis of the hand/wrist
- Wartenberg's syndrome
- Rheumatoid Arthritis
You doctor or therapist will most likely administer the Finkelstein's test, especially if you already suspect you are suffering from De Quervain's syndrome. Imaging, such as X-rays, are usually not deemed necessary or helpful in a diagnosis for De Quervain's syndrome.