The problem is a swelling of the tendon sheath around the tendons passing along the distal radial aspect of the wrist. This sheath runs through a tight tunnel holding the tendon down to bone, and this swollen sheath passing through a tight tunnel results in significant pain. For this problem, there are three modes of treatment: no treatment, conservative treatment, and surgerical treatment.
As a last resort, when conservative treatment has failed, surgical decompression of the tendon by opening up the pulley can be performed as an outpatient procedure under local anesthesia with a small incision. This has a good success rate.
Conservative treatment consists of modification of activities, use of a thumb brace and occasional icing, and then possible use of anti-inflammatory medications. If the pain still persists despite the recommended treatment mentioned above, a cortisone injection can be helpful. No more than three cortisone injections are recommended per year in any one location.