De Quervain's Disease

What is De Quervain’s Disease?

De Quervain’s disease, or De Quervain’s tenosynovitis, is inflammation and swelling of the two tendons that run along the thumb side of the wrist. As the tendons and their sheath swell, movement through the sheath becomes painful and restricted.

It is driven by repetitive thumb and wrist movements: lifting, gripping, texting, and similar tasks done over and over. It is common in new parents who repeatedly lift a baby, and it can also follow a direct injury, or accompany pregnancy and rheumatoid arthritis.

The pain is felt at the base of the thumb and along the thumb side of the wrist. It worsens with gripping or twisting and can be reproduced by the Finkelstein test, where tucking the thumb into the palm and bending the wrist toward the little finger brings on sharp pain.

Symptoms

• Pain at the base of the thumb and along the thumb-side wrist
• Swelling and tenderness near the wrist
• Pain that worsens with gripping, lifting, or twisting
• A catching or snapping sensation when moving the thumb
• Reduced grip strength
• A positive Finkelstein test

How We Treat It

A precise corticosteroid injection into the tendon sheath is the most effective treatment and often the one we reach for first. Delivered under ultrasound guidance, it places the medication exactly where the tendons are swollen and frequently brings rapid relief. Many people improve within a few weeks of a single well-placed injection combined with a short period of thumb and wrist support.

To prevent the problem returning, our team addresses the movements that caused it. Manual therapy and a guided programme of activity modification and gentle strengthening reduce the load on the tendons and correct the habits that set off the irritation. We keep surgical release in reserve for the few cases that do not settle with these measures.