What is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a condition that results from inflammation of the tendons that control thumb movement—specifically the abductor pollicis longus (APL) and extensor pollicis brevis (EPB). These tendons run through a sheath located at the wrist near the base of the thumb. When the sheath becomes irritated or inflamed, it causes pain, swelling, and reduced thumb mobility.
This condition was first described by Swiss surgeon Fritz de Quervain in 1895 and remains one of the most common causes of wrist pain.
Who is at Risk?
This condition affects people who frequently use their thumbs and wrists in repetitive motions. High-risk groups include:
- New mothers (due to lifting babies)
- Office workers (typing or using smartphones)
- Construction workers or manual laborers
- People engaged in hobbies like gardening or sewing
- Individuals with underlying inflammatory conditions like rheumatoid arthritis
Common Causes
The root cause of De Quervain’s Tenosynovitis is overuse or repetitive strain, but it can also be triggered by:
- Sudden trauma to the wrist or thumb
- Improper lifting techniques
- Hormonal changes during pregnancy or postpartum
- Inflammatory diseases, like lupus or rheumatoid arthritis
Symptoms
De Quervain’s Tenosynovitis symptoms may develop gradually or suddenly. Key symptoms include:
- Pain and swelling near the base of the thumb
- Difficulty gripping or pinching objects
- A catching or snapping sensation when moving the thumb
- Pain that radiates up the forearm
- Increased pain during activities like opening jars or lifting children
One of the most reliable clinical signs is a positive Finkelstein Test—if pain intensifies when making a fist with your thumb inside and bending your wrist sideways, it’s likely De Quervain’s.
Diagnosis
Physicians or physiotherapists usually diagnose De Quervain’s Tenosynovitis based on:
- Physical examination
- Finkelstein Test
- Ultrasound or MRI (rare, but can help rule out other issues)
Why Physiotherapy Is Important
While some mild cases improve with rest, many individuals benefit from targeted physiotherapy treatments that address pain, inflammation, and functional limitations. Physiotherapy is crucial to:
- Reduce pain and swelling
- Restore thumb and wrist movement
- Strengthen hand muscles
- Prevent recurrence
Physiotherapy Treatment Plan for De Quervain’s Tenosynovitis
An effective treatment plan often includes a combination of rest, splinting, manual therapy, therapeutic exercises, and modalities.
- Rest and Activity Modification
The first step is avoiding painful movements, especially repetitive thumb and wrist actions. Activities that involve gripping, pinching, or lifting should be minimized.
Pro tip: If you’re a new parent, use proper baby-lifting techniques or ask for help to avoid aggravating your tendons.
- Thumb Spica Splinting
A thumb spica splint immobilizes the thumb and wrist, reducing tension on the affected tendons. It’s typically worn for 2–4 weeks, even during sleep, and helps:
- Reduce inflammation
- Prevent further strain
- Promote healing
- Pain Relief Techniques
Modalities used by physiotherapists include:
- Ice therapy: Apply cold packs for 10–15 minutes, 2–3 times per day
- Ultrasound therapy: Promotes tissue healing
- TENS (Transcutaneous Electrical Nerve Stimulation): Blocks pain signals
- Manual therapy: Gentle joint mobilization and soft tissue massage to reduce tightness
- Stretching and Strengthening Exercises
Progressive exercise is key to rehabilitation. Start only after the acute pain subsides.
- Tendon Gliding Exercises
These help the tendons move smoothly through the sheath and reduce adhesions. - Wrist Flexor and Extensor Stretches
Gentle stretching improves flexibility and reduces stiffness. - Thumb Abduction Strengthening
Use a rubber band or therapy putty to build thumb and wrist strength. - Eccentric Loading
Introduce resistance exercises to help the tendons rebuild strength and endurance.
Always perform exercises under a physiotherapist’s guidance to avoid re-injury.
- Ergonomic and Postural Training
Your physiotherapist may suggest ergonomic improvements such as:
- Keyboard and mouse placement for office workers
- Lifting strategies for parents or caregivers
- Adaptive tools for household or workplace tasks
Home Care Tips
- Use voice-to-text to reduce typing strain
- Alternate hands when holding objects or babies
- Take frequent breaks from tasks involving the thumb and wrist
- Sleep with your splint if recommended
When to Consider Other Treatments
If conservative physiotherapy fails to resolve symptoms after 6–8 weeks, you may be referred for:
- Corticosteroid injections for temporary relief
- Surgical intervention (rare, only in chronic severe cases)
Prognosis and Recovery Time
With proper physiotherapy, most patients recover within 4 to 8 weeks. Early diagnosis and treatment significantly improve outcomes. Delaying treatment can result in chronic pain or reduced function.
Preventing Recurrence
Even after recovery, maintaining wrist health is vital:
- Warm-up and stretch before using your hands extensively
- Avoid repetitive wrist strain
- Use proper techniques when lifting or typing
- Follow up with periodic hand therapy sessions
Other Related Article for reading
Carpal Tunnel Syndrome (CTS): Causes, Symptoms, Diagnosis, and Treatment
❓ Frequently Asked Questions about De Quervain’s Tenosynovitis
🔹 What is De Quervain’s Tenosynovitis?
De Quervain’s Tenosynovitis is a painful condition involving inflammation of the tendons on the thumb side of the wrist—specifically the abductor pollicis longus and extensor pollicis brevis.
🔹 What is the best splint for De Quervain’s Tenosynovitis?
The thumb spica splint is considered the best splint for De Quervain’s Tenosynovitis. It immobilizes both the wrist and thumb to reduce strain on inflamed tendons.
🔹 Is there a specific brace for De Quervain’s Tenosynovitis?
Yes, a wrist brace or thumb spica brace is designed to support the wrist and thumb. These braces limit movement and reduce pain during daily activities.
🔹 What is the ICD-10 code for De Quervain’s Tenosynovitis?
The ICD-10 code for De Quervain’s Tenosynovitis is M65.4. For side-specific coding:
- Right hand: 41
- Left hand: 42
🔹 What exercises help with De Quervain’s Tenosynovitis?
Helpful exercises include:
- Tendon gliding
- Wrist flexor/extensor stretches
- Thumb abduction with resistance
Download De Quervain’s Tenosynovitis exercises PDF for a printable handout.
🔹 How effective is a cortisone injection for De Quervain’s Tenosynovitis?
Cortisone (steroid) injections are highly effective in reducing inflammation and pain, especially when conservative therapy fails.
🔹 Can De Quervain’s Tenosynovitis come back after surgery?
Yes, recurrence is possible, especially if the underlying causes (repetitive stress, improper lifting) are not addressed.
🔹 How long is the recovery after De Quervain’s Tenosynovitis surgery?
Recovery typically takes 4 to 6 weeks. Patients may need physiotherapy post-surgery for strength and mobility restoration.
🔹 What is the success rate of De Quervain’s Tenosynovitis surgery?
The surgery has a high success rate (90–95%), especially when followed by physiotherapy and ergonomic modifications.
🔹 How does De Quervain’s Tenosynovitis differ from carpal tunnel syndrome?
De Quervain’s causes pain near the thumb base, while carpal tunnel syndrome involves numbness or tingling in the thumb, index, and middle fingers due to median nerve compression.
🔹 Is massage helpful for De Quervain’s Tenosynovitis?
Yes, gentle soft tissue massage can relieve tension, improve circulation, and reduce inflammation when done by a trained therapist.
🔹 Can KT tape or kinesiology taping help De Quervain’s Tenosynovitis?
Yes, KT tape can offload pressure from the tendons and support the wrist/thumb area, aiding in pain relief and function.
🔹 Is De Quervain’s Tenosynovitis common during pregnancy?
Yes. Hormonal changes, fluid retention, and repetitive baby-lifting movements make pregnant and postpartum women especially vulnerable.
🔹 What is the R.I.C.E. method for De Quervain’s Tenosynovitis?
R.I.C.E. stands for Rest, Ice, Compression, and Elevation—an effective approach for managing pain and swelling in the early stages.
🔹 How do you pronounce De Quervain’s Tenosynovitis?
Pronunciation: “duh-KARE-van’s ten-oh-sine-oh-VY-tis”
The name originates from Swiss surgeon Fritz de Quervain.
🔹 Are there downloadable De Quervain’s Tenosynovitis exercise handouts?
Yes, many physiotherapy clinics and health websites provide De Quervain’s Tenosynovitis exercise PDFs for patient use. Click here to download.
🔹 Can acupuncture help De Quervain’s Tenosynovitis?
Yes, some patients find acupuncture beneficial for reducing pain and inflammation, although results may vary.
🔹 What is the CPT code for De Quervain’s Tenosynovitis injection?
The CPT code for a corticosteroid injection into a tendon sheath is typically 20550. Confirm with billing codes in your healthcare region.
🔹 Can I sleep with the splint on for De Quervain’s Tenosynovitis?
Yes, wearing a thumb spica splint at night can prevent unconscious thumb movement and reduce morning stiffness.