Skip to main content
SpringerLink
Log in

Systematic review and meta-analysis on steroid injection therapy for de Quervain’s tenosynovitis in adults

  • General Review
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

de Quervain’s tenosynovitis is a painful condition of the wrist which leads to difficulties in performing activities of daily living.

Aims

This systematic review was conducted to examine the effectiveness of steroid injection therapy as compared to splinting for treatment of de Quervain’s tenosynovitis in adults.

Methods

The following databases were searched for relevant studies, MEDLINE, EMBASE, CINAHL, AMED and PsycINFO (via NHS Evidence), and Cochrane Library (via Cochrane Collaboration). Synonyms and free texts were used to locate studies. The reference lists of articles were checked for related papers. Hand searching was performed for important relevant journals. All searches found 89 studies, out of which 14 were relevant. Two studies were selected according to the inclusion criteria of the systematic review. Data were extracted and analysed for the two selected randomised trials using a fixed effect model at 95 % confidence intervals.

Results

The meta-analysis demonstrated that the total effect estimate was 3 with a narrow 95 % confidence interval (1.89, 4.77). z score for overall effect was 4.66 which was highly significant (p < 0.01). Moderate heterogeneity with I-square test was found to be 64 % but was not significant (p > 0.05). Number needed to treat was 2, which showed that for every two persons treated with steroid injections, one person gets the benefit.

Conclusion

Steroid injection is an effective form of conservative management for de Quervain’s disease although more research is needed to establish the full benefits of the treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ilyas AM, Ast M, Schaffer AA (2007) De-Quervain tenosynovitis of the wrist. J Am Acad Orthop Surg 15:757–764

    PubMed  Google Scholar 

  2. Schned ES (1986) De Quervain tenosynovitis in pregnant and postpartum women. Obstet Gynecol 68:411–894

    Article  CAS  PubMed  Google Scholar 

  3. Batteson R, Hammond A, Burke F (2008) The de Quervain’s screening tool: validity and reliability of a measure to support clinical diagnosis and management. Musculoskeletal Care 6:168–180

    Article  PubMed  Google Scholar 

  4. Weiss AP, Akelman E, Tabatabai M (1994) Treatment of de Quervain’s disease. J Hand Surg Am 19:595–598

    Article  CAS  PubMed  Google Scholar 

  5. de Quervain F (1895) Uerber eine form von chronisher tendovaginitis. Cor-Br F Schweiz aerzte 4:899–903

    Google Scholar 

  6. Finkelstein H (1930) Stenosing tendovaginitis at the radial styloid process. J Bone Joint Surg 12:509–540

    Google Scholar 

  7. Patterson DC (1936) De Quervain’s disease: stenosing tenovaginitis at the radial styloid. N Engl J Med 214:101–102

    Article  Google Scholar 

  8. Keon-Cohen B (1951) De Quervain’s disease. J Bone Joint Surg 33B:96–99

    Google Scholar 

  9. Wright PE (2008) Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Campbell WC, Canale ST, Beaty JH (eds) Campbell’s operative orthopaedics, 11th edn. Mosby/Elsevier, Philadelphia, PA, pp 4299–4230

  10. Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C (2004) Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum 51:642–651

    Article  PubMed  Google Scholar 

  11. Ranney D, Wells R, Moore A (1995) Upper limb musculoskeletal disorders in highly repetitive industries: precise anatomical physical findings. Ergonomics 38(7):1408–1423

    Article  CAS  PubMed  Google Scholar 

  12. Avci S, Yilmaz C, Sayli U (2002) Comparison of nonsurgical treatment measures for de Quervain’s disease of pregnancy and lactation. J Hand Surg Am 27:322–324

    Article  PubMed  Google Scholar 

  13. Valen PA, Foxworth J (2010) Evidence supporting the use of physical modalities in the treatment of upper extremity musculoskeletal conditions. Curr Opin Rheumatol 22(2):194–204

    Article  PubMed  Google Scholar 

  14. Mehdinasab SA, Alemohammad SA (2010) Methylprednisolone acetate injection plus casting versus casting alone for the treatment of de Quervain’s tenosynovitis. Arch Iran Med 13(4):270–274

    CAS  PubMed  Google Scholar 

  15. Peters-Veluthamaningal C, van der Windt DAWM, Winters JC, Meyboom-de Jong B (2009) Corticosteroid injection for de Quervain’s tenosynovitis. Cochrane Database Syst Rev (3). http://www.thecochranelibrary.com. Accessed 11 Dec 2011

  16. Moore JS (1997) De Quervain’s tenosynovitis: stenosing tenosynovitis of the first dorsal compartment. J Occup Environ Med 39(10):990–1002

    Article  CAS  PubMed  Google Scholar 

  17. Crop JA, Bunt CW (2011) Doctor, my thumb hurts. J Fam Pract 60(6):329–332

    PubMed  Google Scholar 

  18. Ta KT, Eidelman D, Thomson JG (1999) Patient satisfaction and outcomes of surgery for de Quervain’s tenosynovitis. J Hand Surg 24A(5):1071–1077

    Article  Google Scholar 

  19. Witt J, Pess G, Gelberman RH (1991) Treatment of de Quervain tenosynovitis. A prospective study of the results of injection of steroids and immobilization in a splint. J Bone Joint Surg Am 73(2):219–222

    CAS  PubMed  Google Scholar 

  20. McKenzie JM (1972) Conservative treatment of de Quervain’s disease. Br Med J 4:659–660

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Anderson BC, Manthey R, Brouns MC (1991) Treatment of De Quervain’s tenosynovitis with corticosteroids. A prospective study of the response to local injection. Arthritis Rheum 34:793–798

    Article  CAS  PubMed  Google Scholar 

  22. Zingas C, Failla JM, Van Holsbeeck M (1998) Injection accuracy and clinical relief of de Quervain’s tendinitis. J Hand Surg Am 23(1):89–96

    Article  CAS  PubMed  Google Scholar 

  23. Christie BGB (1955) Local hydrocortisone in de Quervain’s disease. Br Med J 1(4929):1501–1503

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Lane LB, Boretz RS, Stuchin SA (2001) Treatment of de Quervain’s disease: role of conservative management. J Hand Surg Br 26(3):258–260

    Article  CAS  PubMed  Google Scholar 

  25. Harvey FJ, Harvey PM, Horsley MW (1990) De Quervain’s disease: surgical or nonsurgical treatment. J Hand Surg Am 15:83–87

    Article  CAS  PubMed  Google Scholar 

  26. Richie CA, Briner WW (2003) Corticosteroid injection for treatment of de Quervain’s tenosynovitis: a pooled quantitative literature evaluation. J Am Board Fam Pract 16(2):102–106

    Article  PubMed  Google Scholar 

  27. Katz S (1983) Assessing selfmaintenance: activities of daily living, mobility and instrumental activities of daily living. JAGS 31(12):721–726

    CAS  Google Scholar 

  28. McDowell I, Newell C (1996) Measuring health: a guide to rating scales and questionnaires, 2nd edn. Oxford University Press, New York

    Google Scholar 

  29. CRD (2009) Systematic reviews: CRD guidance for undertaking reviews in healthcare. http://www.york.ac.uk/inst/crd/SysRev/!SSL!/WebHelp/SysRev3.htm. Accessed 11 Dec 2011

  30. Khan K, Kunz R, Kleijnen J, Antes G (2009) Systematic reviews to support evidence based medicine. How to review and apply findings of healthcare research. Royal Society of Press, Ltd, London, pp 27–33

    Google Scholar 

  31. OpenGrey (2011) http://www.opengrey.eu/about. Accessed 14 Dec 2011

  32. Current Controlled Trials (2011) Current controlled trials. http://www.controlled-trials.com/. Accessed 11 Dec 2011

  33. Glasziou P (2001) Systematic reviews in health care : a practical guide. Cambridge University Press, Port Chester, NY, pp 66-67. http://site.ebrary.com/lib/edgehill/Doc. Accessed 11 Dec 2011

  34. PRISMA. (2009) http://www.prisma-statement.org/index.htm. Accessed 23 Dec 2011

  35. RefWorks. (2009) RefWorks—an online research management, writing and collaboration tool. http://www.refworks.com/refworks/. Accessed 13 Dec 2011

  36. Berlin JA (1997) Does blinding of readers affect the results of meta-analyses? University of Pennsylvania Meta-analysis Blinding Study Group. Lancet 350(9072):185–186

    Article  CAS  PubMed  Google Scholar 

  37. Higgins JPT, Deeks JJ (2008) Chapter 7: selecting studies and collecting data. In: Higgins JPT, Green S (eds) Cochrane Handbook of systematic reviews of intervention (Version 5.0.1). http://www.cochrane-handbook.org. Accessed 11 Dec 2011

  38. Peters-Veluthamaningal C, Winters JC, Groenier KH, Meyboom-DeJong B (2009) Randomised controlled trial of local corticosteroid injections for de Quervain’s tenosynovitis in general practice. BMC Musculoskelet Disord 10:131

    Google Scholar 

  39. Kosuwon J (1996) Treatment of de Quervain tenosynovitis: a prospective randomized controlled study comparing the results of steroid injection with and without immobilization in a splint. J Clin Epidemiol 1(1):5S

    Article  Google Scholar 

  40. Jirarattanaphochai K, Saengnipanthkul S, Vipulakorn K, Jianmongkol S, Chatuparisute P, Jung S (2004) Treatment of de Quervain disease with triamcinolone injection with or without nimesulide. A randomized, double-blind, placebo-controlled trial. J Bone Joint Surg 86-A(12):2700–2706

    Google Scholar 

  41. Goldfarb CA, Gelberman RH, McKeon K, Chia B, Boyer MI (2007) Extra-articular steroid injection: early patient response and the incidence of flare reaction. J Hand Surg 32(10):1513–1520

    Article  Google Scholar 

  42. Furlan AD, Pennick, V., Bombardier, C. & van Tulder, M. (2009) Editorial Board, Cochrane Back Review Group. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine 34(18):1929–1941

    Google Scholar 

  43. Huisstede BM, van Middelkoop M, Randsdorp MS, Glerum S, Koes BW (2010) Effectiveness of interventions of specific complaints of the arm, neck, and/or shoulder: 3 musculoskeletal disorders of the hand. An update. Arch Phys Med Rehabil 91(2):298–314

    Google Scholar 

  44. Detsky AS, Naylor CD, O’Rourke K, McGeer AJ, L’Abbe KA (1992) Incorporating variations in the quality of individual randomized trials into meta-analysis. J Clin Epidemiol 45(3):255–265

    Article  CAS  PubMed  Google Scholar 

  45. RevMan (2011) Review manager. Version 5.1. The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen

  46. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Each author certifies that he has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Author information

Authors and Affiliations

  1. The Royal Oldham Hospital, Oldham, UK

    Muhammad Omer Ashraf

  2. Rochdale Infirmary, Rochdale, UK

    V. G. Devadoss

Authors
  1. Muhammad Omer Ashraf
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. G. Devadoss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Muhammad Omer Ashraf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ashraf, M.O., Devadoss, V.G. Systematic review and meta-analysis on steroid injection therapy for de Quervain’s tenosynovitis in adults. Eur J Orthop Surg Traumatol 24, 149–157 (2014). https://doi.org/10.1007/s00590-012-1164-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-012-1164-z

Keywords

Search

Navigation