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de Quervain’s Tenosynovitis

Overview

De Quervain’s tenosynovitis is a painful condition that happens when on the tendons on the thumb side of the wrist become inflamed. This swelling makes it hard to move the thumb and wrist, especially when gripping or twisting.

Doctors usually describe De Quervain’s tenosynovitis as a single condition, but it can vary in severity. In early stages, symptoms may be mild and only occur with activity. In later stages, pain and stiffness may persist even at rest.

Common symptoms include:

  • Pain at the base of the thumb, which may spread to the forearm or the elbow.
  • Swelling or redness around the wrist.
  • Difficulty gripping objects, twisting the wrist, or lifting things.
  • A “sticking” or catching feeling when moving the thumb.

Factors that increase the risk of developing De Quervain’s tenosynovitis include:

  • Repeated wrist and thumb movements, such as lifting, typing, or using a smartphone.
  • Women are more commonly affected than men.
  • Age between 40 and 59 years.
  • Pregnancy and breastfeeding, due to hormonal changes and baby care activities.
  • Medical conditions such as rheumatoid arthritis, diabetes, and thyroid disorders.

Doctors usually confirm the diagnosis using:

  • Physical examinations, which may include simple tests, such as asking the patient to make a fist with the thumbs inside and bending it towards the little finger to check for pain.
  • Ultrasound, which can show inflammation in the tendon sheath.
  • Magnetic resonance imaging (MRI), which is needed when the other diagnostic tests are inconclusive.
     

Treatment aims to reduce pain and improve movement.

  • Non-surgical treatment: The primary aim of the non-surgical treatment is to reduce pain. These treatment methods include:
    • Anti-inflammatory medicines.
    • Splints to rest the affected area (keeping the thumb in an upright position).
    • Ice packs to ease discomfort.
    • Simple lifestyle changes, such as avoiding repetitive wrist movements.
    • Steroid injections (usually no more than 1–2) to help reduce the symptoms by approximately 50%–80%.
  • Surgical treatment: Surgery may be suggested if symptoms do not improve with non-surgical treatment options have failed.
    • A small (1–2 inch) cut at the base of the thumb to release the thickened tendon sheath and relieve the symptoms.
    • Post-surgery care:
      • A pressure dressing is usually applied for 2 weeks following which the sutures are removed.
      • Physiotherapy is usually initiated after suture removal and involves mobilisation and strengthening exercises.

You should see a doctor if:

  • Wrist or thumb pain lasts for more than a few weeks.
  • Pain interferes with daily activities like lifting, writing, or typing.
  • Swelling, stiffness, or weakness gets worse over time.

You can lower the risk of De Quervain’s tenosynovitis by:

  • Taking breaks during repetitive tasks that involve the wrist and thumb.
  • Using proper hand and wrist posture while typing, lifting, or holding objects.
  • Practising gentle stretches and exercises to strengthen the wrist and thumb.
  • Avoiding sudden increases in repetitive wrist activities.

You may need to consult:

  • An orthopaedic specialist for diagnosis and treatment.
  • A physiotherapist for exercises and rehabilitation.
  • In some cases, a hand surgeon if surgery becomes necessary.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.