The rope-like structures at the base of your thumb connect muscles to bones and allow you to move your thumb. When these tendons become irritated or constricted in their tendon tunnel, it can cause pain, swelling and difficulty moving the thumb and wrist.
What Is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis (also called De Quervain’s tendinosis) occurs when the first extensor compartment — the tunnel through which the thumb tendons pass — becomes narrowed or irritated.
This can happen if the soft tissues around the tendons thicken or if swelling increases within the tunnel. As a result, thumb and wrist movements such as grasping, twisting or forming a fist can become painful.
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Causes of De Quervain’s Tenosynovitis
While the exact cause of De Quervain’s tenosynovitis is not fully understood, several factors can contribute:
- Overuse or repetitive movements of the thumb or wrist
- Hormonal changes, such as during pregnancy
- Swelling, including that caused by rheumatic disease or after childbirth
New mothers, in particular, seem to be more likely to develop this condition 4–6 weeks after delivery due to repetitive lifting and carrying of the baby.
Symptoms of De Quervain’s Tenosynovitis
Common symptoms of De Quervain’s tenosynovitis include:
- Pain and tenderness along the thumb side of the wrist, especially when forming a fist or turning the wrist
- Pain that can travel up the forearm
- Swelling over the thumb side of the wrist
- “Catching” or “snapping” sensation when moving the thumb
- Difficulty moving the thumb or wrist due to pain or swelling
Symptoms may affect people of all ages and can range from a dull ache to sharp pain, often worsening with activity.
Treatments for De Quervain’s Tenosynovitis
Many patients find relief without surgery. Non-surgical options include:
- Splints or braces to restrict movement of the thumb and wrist
- Anti-inflammatory medications
- Cortisone injections to reduce inflammation
- Avoiding movements that aggravate symptoms
- Hand therapy
Hand therapy exercises may include isometrics, weight-bearing exercises and proprioceptive drills to prevent recurrence.
De Quervain’s Tenosynovitis Surgery
If symptoms persist despite conservative care, surgery may be recommended. During the procedure, the surgeon opens the tendon tunnel to relieve pressure on the tendons, allowing them to glide smoothly. Recovery is typically, but not always, supported with hand therapy to regain strength and prevent stiffness.
How to Prevent De Quervain’s Tenosynovitis
To reduce the risk of De Quervain’s tenosynovitis:
- Avoid repetitive or forceful thumb movements when possible
- Use larger joints and muscle groups to perform tasks instead of overworking the thumb
- Take breaks during activities that require gripping or twisting
- Strengthen and stretch the thumb and wrist regularly
Although this surgery is routine and safe, avoiding surgery or even more invasive non-surgical treatment is always the best option, if possible.
De Quervain’s Tenosynovitis Treatment at OrthoNebraska
Need relief from De Quervain’s tenosynovitis in the Omaha area? At OrthoNebraska, we want to make sure that our patients feel understood, safe and confident to take on an appropriate treatment plan. With proper management, we can help you reduce pain levels and improve quality of life.
