De Quervain's Tenosynovitis
De Quervain's tenosynovitis can cause persistent wrist pain, reduced thumb mobility, and difficulty with everyday tasks. Dr Foo provides thorough assessment and personalised treatment to relieve symptoms and restore hand function.
MBBS (University of London) | MMed (Ortho) | FRCSEd (Ortho) | FAMS (Ortho)
What Is De Quervain's Tenosynovitis?
De Quervain's tenosynovitis is a condition where the tendons on the thumb side of
the wrist become swollen and irritated, causing pain and difficulty with hand and wrist
movements. It happens when the narrow tunnel that the tendons pass through becomes
thickened, making it harder for the tendons to move smoothly.
It is also known as "mummy’s thumb" or "washerwoman’s sprain," as it often affects new
mothers and people who perform repeated gripping or twisting activities.
What Causes De Quervain's Tenosynovitis?
De Quervain's tenosynovitis develops when the tendons around the thumb and wrist are placed under repeated strain or affected by underlying conditions. It is seen more often in women above 40, particularly during and after pregnancy. The main contributing factors include:
- Repetitive thumb and wrist motions such as lifting a baby, wringing clothes, prolonged typing, or frequent smartphone use.
- Hormonal and physical changes during pregnancy and after childbirth, which increase tendon sensitivity.
- Direct injury to the wrist, which can trigger inflammation in the tendons.
- Underlying medical conditions such as rheumatoid arthritis that can weaken or irritate tendons.
What Are the Symptoms of De Quervain's Tenosynovitis?
The main symptom of De Quervain's tenosynovitis is pain on the thumb side of the wrist that worsens with gripping, twisting, or lifting movements. Other common signs include:
- Tenderness when pressing on the affected area, especially over the thumb tendons.
- Swelling around the wrist and base of the thumb, sometimes accompanied by warmth.
- Difficulty with daily tasks such as opening jars, turning door handles, or lifting a child due to pain.
- A snapping or sticking sensation when moving the thumb, as if the tendons are catching.
- Pain radiating up the forearm in more advanced or severe cases.
Complications of De Quervain's Tenosynovitis
If left untreated, De Quervain's tenosynovitis may lead to persistent pain and stiffness
that interfere with daily activities. The thumb can become less mobile, making it
harder to perform tasks that require grip strength or fine movement.
Over time, the tendons may thicken and scar, which further restricts smooth motion. Some people
develop compensatory strain in the hand or forearm as they adjust their movements,
and symptoms can also recur if repetitive activities are not addressed.
If left untreated, De Quervain's tenosynovitis can progressively limit hand function and affect daily activities. If you are experiencing ongoing wrist pain, swelling, or difficulty with thumb movements, consult a hand specialist for a thorough evaluation and a personalised treatment plan. How Is De Quervain's Tenosynovitis Diagnosed?
De Quervain's tenosynovitis is typically diagnosed through a clinical assessment rather than advanced imaging. The process usually involves:
- Physical examination of the wrist, checking for pain, swelling, and tenderness along the tendons.
- Reviewing medical and activity history, including recent pregnancy or childcare, daily activities that involve repetitive wrist use, and any previous injuries or inflammatory conditions.
- Performing the Finkelstein’s manoeuvre, where the thumb is placed in the palm and the wrist bent towards the little finger; sharp pain on the thumb side strongly suggests the condition.
Imaging tests like ultrasound or X-rays are not typically needed but may be conducted to rule out other wrist problems if the diagnosis is uncertain.
How Is De Quervain's Tenosynovitis Treated?
Treatment for De Quervain's tenosynovitis focuses on reducing inflammation, relieving pain, and restoring hand function. Non-surgical measures are recommended first, while surgery is reserved for persistent cases.
| Treatment | Description & Purpose |
|---|---|
| Non-Surgical Management | |
| Pain Management | Includes oral medications such as non-steroidal anti-inflammatory drugs (NSAIDs), which relieve pain and reduce inflammation. Corticosteroid injections may also be used to target inflammation directly within the tendon tunnel and provide relief when other measures are insufficient. Cold compresses can further reduce irritation, while heat therapy helps relax surrounding muscles. |
| Activity Modification | Avoiding or adjusting repetitive motions such as lifting, twisting, or wringing reduces stress on the thumb tendons and prevents symptoms from worsening. |
| Splinting | A thumb spica splint is used to immobilise the thumb and wrist, reducing tendon movement and giving them time to rest and recover. |
| Hand Therapy | Exercises, stretches, and ergonomic advice provided by a physiotherapist restore tendon flexibility and strength, improve wrist mobility, and lower the risk of recurrence. |
| Surgical Intervention | |
| Surgical Release | A minor outpatient procedure that involves releasing the tight tendon tunnel to relieve pressure on the tendons. This restores smooth tendon gliding and reduces pain, followed by rehabilitation exercises to regain hand strength and movement. |
Can De Quervain's Tenosynovitis Be Prevented?
De Quervain's tenosynovitis can sometimes be prevented by reducing repetitive strain on the thumb and wrist and adopting good hand ergonomics. Helpful strategies include:
- Using both hands to lift objects, especially heavier items, to distribute load evenly.
- Keeping wrists in a neutral position during tasks such as typing or using a smartphone.
- Taking regular breaks from repetitive activities to reduce tendon fatigue.
- Adjusting baby care techniques, such as varying the way a child is lifted or supported, to ease stress on the wrist.
- Incorporating stretching and strengthening exercises for the hands and wrists to maintain tendon flexibility and reduce the risk of recurrence.
When Should You Seek Medical Attention for De Quervain's Tenosynovitis?
You should seek medical attention if
wrist pain on the thumb side persists for more than a few days, interferes with daily
activities, or worsens despite rest. Medical evaluation is also important if swelling
increases, the pain spreads up the forearm, or you have difficulty moving your thumb.
Early assessment and treatment can prevent the condition from becoming more severe and may reduce
the need for invasive interventions.
Every patient deserves a treatment plan tailored to their needs. We start with non-surgical approaches before considering more invasive interventions.
Dr Foo Gen Lin
Where to Seek Diagnosis and Treatment for De Quervain's Tenosynovitis?
Apex Novena
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101 Irrawaddy Rd, #18-12 Royal Square Medical Centre, Singapore 329565
Nearest MRT: NS20 Novena
Apex East Coast
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112 E Coast Rd, #03-03/04 i12 Katong, Singapore 428802
Nearest MRT: TE26 Marine Parade
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Frequently Asked Questions (FAQs)
De Quervain's tenosynovitis may improve on its own if repetitive strain is avoided, but many people require treatment for lasting relief. Mild cases can settle with rest, activity changes, and splinting, but persistent pain often needs additional therapies such as physiotherapy or corticosteroid injections. Early management reduces the risk of tendon thickening, scarring, or long-term mobility problems, so professional evaluation is recommended if symptoms do not resolve within a short period.
If you have De Quervain's tenosynovitis, you should avoid repetitive thumb and wrist activities that strain the tendons, such as heavy lifting, wringing, or prolonged smartphone use. You should also avoid forceful gripping and twisting motions, which can worsen inflammation and delay recovery. Ignoring pain and continuing with aggravating activities increases the risk of chronic symptoms. Always follow your doctor’s instructions to support proper healing.
De Quervain's tenosynovitis is usually managed with non-surgical treatments such as rest, activity modification, splinting, physiotherapy, and pain management. Surgery, called a De Quervain’s release, may be considered if symptoms do not improve with conservative care. The most appropriate approach depends on the severity and duration of symptoms, and early medical assessment helps guide treatment and may support a quicker return of hand function.
Both ice and heat can help with De Quervain's tenosynovitis, but they work differently. Applying ice reduces inflammation and numbs pain, making it useful during flare-ups or after activity. Heat therapy relaxes muscles and improves circulation, which may help ease stiffness around the wrist. These methods provide supportive relief but do not address the underlying tendon problem, so they are usually combined with other treatments. Always follow your doctor’s instructions to support optimal recovery.
Gentle massage may temporarily ease discomfort in De Quervain's tenosynovitis by improving circulation and reducing stiffness, but deep or forceful massage can aggravate tendon irritation. Massage should not replace medical treatment, and techniques should be guided by a physiotherapist or hand specialist if used as part of a treatment plan. The focus of care remains reducing inflammation, protecting the tendons, and restoring function. It is best to follow your doctor’s advice on whether massage is suitable for your condition.
The fastest recovery from wrist tendonitis, including De Quervain’s tenosynovitis, usually involves reducing tendon strain and addressing inflammation through rest, splinting, and pain management. Physiotherapy can support long-term recovery by restoring mobility and strength. While recovery time varies depending on severity and activity demands, early diagnosis and tailored treatment give the best chance of a quicker return to normal function.
Carpal tunnel syndrome and De Quervain’s tenosynovitis affect different structures in the wrist and cause distinct symptoms. Carpal tunnel involves compression of the median nerve, leading to numbness, tingling, and weakness in the hand and fingers. De Quervain’s tenosynovitis affects the thumb tendons, causing pain and swelling on the thumb side of the wrist that worsens with gripping or lifting. If you are experiencing persistent pain or numbness in your thumbs and wrist, it is advisable to seek proper diagnosis and treatment.
Wearing a wrist brace at night for De Quervain's tenosynovitis may help keep the thumb and wrist in a neutral position, reducing strain during sleep. Some people find this lessens pain and stiffness in the morning. However, continuous use is not always necessary, and brace wear should be guided by your doctor to ensure it supports recovery without causing joint stiffness or over-reliance.
Thumb arthritis and De Quervain’s disease affect different structures in the hand. Thumb arthritis involves degeneration of the joint at the base of the thumb, leading to pain, stiffness, and grinding with movement. De Quervain’s disease, or tenosynovitis, affects the tendons on the thumb side of the wrist, causing pain that worsens with gripping or lifting. While both conditions cause thumb pain, their causes, examination findings, and treatments differ.
A wrist brace for tendonitis, including De Quervain’s tenosynovitis, is usually worn for a few weeks to limit tendon movement and support healing. The exact duration depends on symptom severity and response to treatment. Bracing is often combined with activity modification and physiotherapy to prevent stiffness and aid long-term recovery. It is best to consult your doctor on the appropriate duration to ensure proper healing.
You may be able to drive with De Quervain's tenosynovitis if pain is mild and wrist function is preserved, but driving can be difficult when gripping the wheel worsens symptoms. Activities that require twisting, turning, or firm grip may aggravate the condition and compromise safety. It is advisable to consult your doctor for guidance on whether driving is appropriate for your condition.
Most people with De Quervain’s tenosynovitis improve with non-surgical treatments such as splinting, pain management, and physiotherapy, so surgery is not usually the first step. Surgery, called a De Quervain’s release, is considered only when symptoms persist despite conservative care. It is best to consult a hand specialist who can explain the potential risks and benefits of surgery and how it may affect your daily function.