De Quervain’s Tendinosis

What is de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is painful inflammation around your thumb tendons. It’s also called de Quervain’s tendinosis or de Quervain’s tendinitis. Healthcare providers sometimes use these names interchangeably to refer to the same condition.

Tendons link your muscles to your bones. They’re cords of strong, flexible tissue, similar to a rope. When you contract (squeeze) a muscle, tendons pull the bones they’re attached to and make them move. Two tendons connect your thumb to your wrist.

Usually, tendons slide easily through a tunnel of tissue called a sheath. De Quervain’s tenosynovitis happens when something makes the sheath around your thumb tendons swell or thicken. This swelling causes extra friction when you use your thumb and wrist. When this happens, certain thumb and wrist motions are painful and more difficult. De Quervain’s tenosynovitis usually causes pain near the base of your thumb that can extend (radiate) into your forearm.

How common is de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is one of the most common forms of tenosynovitis. Experts estimate that it affects around 1% of people in the U.S. each year.

What are de Quervain’s tenosynovitis symptoms?

The most common de Quervain’s tenosynovitis symptom is pain in your wrist on the same side as your thumb (the radial side). Some people notice the pain suddenly or all at once, but it can also develop over time. The pain usually:

• Gets worse while you’re using your hand, wrist and thumb.
• Spreads (radiates) from your wrist into your thumb or forearm.
• Gets worse when you’re gripping or pinching objects.

Other symptoms include:

• Swelling.
• A snapping or popping feeling in your wrist when you move your thumb.
• Stiffness or your thumb feeling less smooth.
• Numbness in your wrist or thumb.

What causes de Quervain’s tenosynovitis?

Anything that irritates your thumb tendons can cause de Quervain’s tenosynovitis. The most common causes include:

• Overusing your thumb or wrist.
• Repetitive grasping or gripping for work or a hobby.
• Health conditions that cause inflammation (including arthritis).
• Getting hit directly on your thumb or wrist.

Activities that require you to perform repetitive motions while gripping an object tightly can cause de Quervain’s tenosynovitis, including:

• Sports like tennis, racquetball or skiing.
• Using a hammer or other tools.
• Lifting young children.
• Gardening.

De Quervain’s tenosynovitis risk factors

Anyone can experience de Quervain’s tenosynovitis, but certain groups of people are more likely to develop it, including:

• Women and people assigned female at birth.
• People older than 40.
• Childcare workers.
• Parents with young children.
• People who do manual labor or work with their hands.
• Athletes.

How is de Quervain’s tenosynovitis diagnosed?

A healthcare provider will diagnose de Quervain’s tenosynovitis with a physical exam. They’ll examine your thumb and wrist. Tell your provider when you first noticed pain around your wrist and if any activities make it noticeably worse.

Which tests do providers use to diagnose de Quervain’s tenosynovitis?

Healthcare providers use a physical motion called the Finkelstein test to diagnose de Quervain’s tenosynovitis. Your provider will have you make a fist with your fingers wrapped over your thumb. Holding that fist shape, you’ll move your wrist up and down (as if you were shaking someone’s hand). This position and motion singles out your thumb tendons. If you have de Quervain’s tenosynovitis, it’ll usually hurt when you move your wrist during the Finkelstein test.

Your provider might also use imaging tests like X-rays to check your wrist joint for signs of other conditions that cause wrist pain (like osteoarthritis).

How is de Quervain’s tenosynovitis treated?

A healthcare provider will usually suggest treatments for de Quervain’s tenosynovitis that manage your symptoms while your thumb tendons and their sheaths heal. The most common treatments include:

• Wearing a splint or brace: This will keep your wrist and thumb held in place (immobilized) to take pressure off your thumb tendons.
• Icing your wrist: Icing can reduce swelling and relieve pain. Wrap ice packs in a thin towel and apply them to your wrist for 20 minutes at a time a few times a day.
• Rest:Avoid using your affected wrist as much as possible. You’ll need to avoid playing sports or doing repetitive motions (especially the specific activity that caused the de Quervain’s tenosynovitis).
• NSAIDs: Over-the-counter NSAIDs reduce inflammation and relieve pain. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
• Corticosteroids: Corticosteroids are prescription anti-inflammatory medications. Your provider might inject a corticosteroid into your affected tendon sheath.

De Quervain’s tenosynovitis exercises

Your provider may suggest stretches and exercises that increase your wrist strength and flexibility. The most common exercise is gripping a tennis ball:

• Grip a tennis ball lightly for a few minutes.
• Rest for a few minutes.
• If you didn’t feel any pain, repeat the grip with slightly more pressure.

Your provider will tell you how often (and for how long) to stretch or exercise your wrist. Don’t exercise through pain. If any stretch or exercise hurts, stop and contact your provider.

De Quervain’s tenosynovitis surgery

Most people don’t need surgery to treat de Quervain’s tenosynovitis. But your provider might recommend surgery if other treatments don’t relieve your symptoms.

De Quervain’s tenosynovitis surgery is usually an outpatient procedure, which means you can go home the same day. Your surgeon will make a tiny cut (incision) in the sheath around your thumb tendons. This will give your tendons more space to move. Your surgeon will let you know what to expect if you need surgery, including how long you’ll need to recover.

How soon after treatment will I feel better?

Your provider will tell you how long you’ll need treatment for de Quervain’s tenosynovitis. Most people need to wear a splint or brace for a few weeks.

Don’t resume physical activities before your provider says it’s OK, even if you start feeling better. If you put too much pressure on your tendons before they’ve healed, you’re more likely to re-injure them.

Can de Quervain’s tenosynovitis be prevented?

The best way to prevent de Quervain’s tenosynovitis is to avoid overusing your thumbs and wrists:

• Learn the proper technique and wear proper protective equipment for sports, work and any physical activity.
• Ease into new exercises or activities to avoid injury.
• Take breaks if you’re doing a repetitive task.
• Don’t “play through the pain” if your wrist hurts during or after physical activity.
• Give your body time to rest and recover after intense activity.

How long does it take to recover from de Quervain’s tenosynovitis?

It usually takes a few weeks for your tendons to heal after you’re diagnosed with de Quervain’s tenosynovitis. How long you’ll need depends on what caused the inflammation and how severe your symptoms are.

Ask your provider when you can resume physical activities. Don’t return to a sport, hobby or job motion that caused de Quervain’s tenosynovitis before your provider says it’s safe to.

What happens if de Quervain’s tenosynovitis goes untreated?

De Quervain’s tenosynovitis is very treatable and is usually a short-term issue. But if it’s not treated, it’s more likely that you’ll need surgery or experience complications. If you put too much pressure on your thumb tendons after you start experiencing de Quervain’s tenosynovitis symptoms, your tendon sheath can burst or your tendon may tear. It’s rare, but some people with untreated de Quervain’s tenosynovitis can permanently lose some function or range of motion (how far you can move a part of your body) in their thumb and wrist.

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice pain or other symptoms of de Quervain’s tenosynovitis. Don’t ignore symptoms, especially if they get worse during or after physical activity.

What questions should I ask my doctor?

• Do I have de Quervain’s tenosynovitis or another condition that causes wrist pain?
• How long will I need to wear a splint or brace?
• Will I need surgery for de Quervain’s tenosynovitis?
• When can I return to physical activities?

A note from Cleveland Clinic

De Quervain’s tenosynovitis is swelling in the sheath around your thumb tendons. It can make it painful and hard to use your thumb and wrist. Fortunately, most people only need rest, at-home treatments and to wear a splint or brace for a few weeks while their tendons and tendon sheaths heal.

Tell your healthcare provider if you’ve started a new activity or hobby that puts pressure on your thumbs and wrists, or if you use your hands a lot for work. They’ll help you find ways to manage your symptoms and return to the activities you love as soon as it’s safe.