De Quervain’s tenosynovitis refers to inflammation of the tendons in the thumb. A person with the condition will experience pain when they move their thumb, but several treatments can ease symptoms.

Health experts may use many names to describe this condition, including de Quervain’s tendinopathy and de Quervain’s tendinosis. Additionally, as it affects the thumb, some people may describe it as gamer’s thumb, texter’s thumb, or mommy thumb.

The condition takes its name from Swiss surgeon Fritz de Quervain, who identified it in 1895. De Quervain’s tenosynovitis typically occurs due to overuse, and both non-surgical and surgical options are available to help relieve discomfort.

This article discusses the condition, including causes, treatments, and diagnosis.

A person texting who may experience De Quervain's tendinopathy.Share on Pinterest
Westend61/Getty Images

A doctor will create a treatment plan and decide if non-surgical options can relieve symptoms or if a person will require surgery.

Non-surgical options

Non-surgical treatment options can include:

  • Having corticosteroid injections: Steroid injections may help to reduce swelling and pain.
  • Wearing a splint or brace: This may help immobilize the wrist, allowing a person to rest their thumb and wrist.
  • Taking anti-inflammatory medication (NSAIDs): Medication such as ibuprofen can also help to reduce swelling and relieve pain.
  • Avoiding certain activities: Stopping activities that may aggravate a person’s thumb and wrist can help relieve symptoms.

Surgical options

If non-surgical options are unsuccessful, a doctor may suggest surgery. In most cases, a surgeon can perform a procedure known as a release. This involves making an incision to open, or release, the tight band over the thickened part of the tendon, which provides more room for the irritated tendons and allows them to move freely without pain.

If a person takes proper care during the recovery process, they can usually return to their daily routine within a few weeks.

Typically, a doctor will perform a physical exam to help diagnose de Quervain’s tenosynovitis. They may also request a person to perform the Finkelstein’s test. This involves the individual placing their thumb in the palm of their hand and making a fist. The doctor will then ask them to bend their wrist in the direction of their little finger.

The test for de Quervain’s tenosynovitis is positive if this movement causes tendon pain on the thumb side of the wrist.

Doctors usually recommend that people with de Quervain’s tenosynovitis wear a splint for a few weeks. During this time, they may also suggest removing the splint to carry out some exercises. These exercises may include:

Preparing for the exercises

People should use these exercises for rehabilitation and only when the initial pain has eased.

The first step to tackling de Quervain’s tenosynovitis is resting from the activity or activities that have caused the pain. Wearing a splint and regularly applying heat or cold packs will also help.

De Quervain’s tenosynovitis describes the thickening of the soft tissue in the wrist. This can refer to the sheath — also known as the synovium — that surrounds the two tendons between the wrist and the thumb, or the tendons themselves within the tunnel.

Tendons are strong bands of tissue that attach muscles to bone. In the thumb-side of the wrist, they are involved in moving the thumb. As the synovium or tendons swell and thicken, it becomes painful for a person to move their thumb.

The condition usually occurs from strain, overuse, repetitive movement, or injury to the thumb. Activities linked to de Quervain’s include:

  • golf
  • playing the piano
  • typing
  • carpentry
  • carrying a child

In other cases, it may occur due to scar tissue formation from inflammatory arthritis. Some people may also experience it during pregnancy and nursing.

The main symptoms people experience are pain and swelling at the base of the thumb. These can lead to:

  • pain when moving the thumb or wrist
  • pain when making a fist
  • swelling and tenderness on the side of the wrist
  • feeling or hearing creaking as the tendons slide through the sheath
  • reduced grip strength

Movements involving the thumb and wrist — including pinching, grasping, or wringing — will worsen the pain.

Carpal tunnel syndrome is a painful condition that also affects the wrist. However, while de Quervain’s tenosynovitis describes thickening of the tendon and tendon sheath, carpal tunnel instead refers to compression of the median nerve.

This nerve runs from the forearm into the palm of the hand and passes through the carpal tunnel, which is a narrow passageway of ligament and bone as the base of the hand. It helps provide feeling to some fingers and controls some small muscles at the base of the thumb. Symptoms include pain, numbness, and tingling in the hand and forearm.

If the exercises make the pain worse, or if the pain does not reduce after 4–6 weeks, it is advisable for people to consult a doctor.

The doctor will usually refer the individual to a physiotherapist or hand specialist for treatment, including exercises, such as those described above.

Alongside specific exercises, treatment for de Quervain’s tenosynovitis will also include rest, anti-inflammatory painkillers, and wearing a splint. If someone still experiences symptoms, a doctor may use steroid injections to reduce the swelling.

If a person’s symptoms do not ease after treatment, a doctor may recommend an ultrasound to establish whether there is another reason for the pain. In some cases, an operation can ease the pain.