DeQuervain’s Tendinitis
DeQuervain’s Tendinitis
DeQuervain’s tendinitis (also called DeQuervain’s tenosynovitis) is a painful condition that affects the tendons on the thumb side of the wrist. It occurs when the two tendons that control thumb movement become irritated or inflamed as they pass through a snug tunnel (called the first dorsal compartment) at the base of the thumb near the wrist. The swelling causes the tendon sheath to thicken, restricting smooth tendon gliding and resulting in pain with thumb and wrist motion.
DeQuervain’s tendinitis is one of the most common causes of wrist and thumb pain, particularly in new parents, individuals who perform repetitive hand and wrist motions, and those who engage in activities that involve forceful gripping with wrist deviation. Early evaluation and appropriate treatment can relieve pain and restore function.
Contributing factors
- Repetitive hand and wrist motions — activities that involve repeated gripping, pinching, wringing, or twisting of the wrist and thumb, such as gardening, racquet sports, knitting, and using hand tools
- New parents — the repetitive lifting and holding of a baby, often with the wrist in an awkward position, is a very common cause (sometimes referred to as “mommy thumb” or “new parent wrist”)
- Direct injury or trauma — a fall or blow to the thumb or wrist area can initiate inflammation
- Inflammatory conditions — rheumatoid arthritis and other inflammatory conditions can contribute to tendon sheath swelling
- Hormonal changes — pregnancy and the postpartum period are associated with increased risk, likely due to fluid retention and hormonal shifts
- Age and gender — most common in women between 30 and 50 years of age
Symptoms
- Pain and tenderness at the base of the thumb on the wrist side (radial side of the wrist)
- Pain that worsens with thumb and wrist movements, especially gripping, pinching, wringing, or twisting motions
- Swelling near the base of the thumb at the wrist
- A “sticking” or “catching” sensation when moving the thumb
- Difficulty gripping or pinching objects
- Pain that may radiate up the forearm or into the thumb
- A positive Finkelstein test — pain at the wrist when making a fist with the thumb tucked inside the fingers and bending the wrist toward the pinky side
Treatment
- Rest / activity modification — avoid repetitive thumb and wrist motions that aggravate pain. Modify how tasks are performed to reduce stress on the affected tendons.
- Splinting — a thumb spica splint immobilizes the thumb and wrist to rest the irritated tendons. Splinting is particularly effective when worn consistently, especially during activities and at night.
- Ice — applying ice to the affected area for 15–20 minutes several times a day can help reduce pain and swelling.
- Medication — anti-inflammatory medications (such as ibuprofen, naproxen) may be recommended to reduce pain and inflammation. Please consult your primary care physician before taking these medications for any duration of time.
- Injection — corticosteroid injections into the tendon sheath are often highly effective for DeQuervain’s tendinitis and can provide significant or complete relief of symptoms. The best results occur when combined with appropriate activity modification and splinting.
- Physical / occupational therapy — therapy may include exercises to improve thumb and wrist mobility, strengthening exercises, and techniques to modify activities and reduce strain on the tendons.
- Surgery — if symptoms persist despite appropriate non-operative treatment, a surgical release of the tendon sheath may be recommended. The procedure opens the compartment to create more room for the tendons to glide freely. This is typically performed as a minor outpatient procedure.
When to seek care
If pain at the base of your thumb or wrist persists for more than a few weeks, limits your ability to grip or use your hand, or does not improve with rest and over-the-counter treatments, evaluation by a specialist is recommended. Early treatment can prevent the condition from becoming chronic and more difficult to resolve.
