De Quervain's Tenosynovitis

Tendonitis of the Wrist Caused by Overuse

Wrist Pain and Mouse
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De Quervain's tenosynovitis is a condition that causes pain associated with movement of the thumb and wrist. The cause of the pain of  de Quervain's is inflammation within a confined area around the base of the thumb. This inflammation is caused by a tendon problem called stenosing tenosynovitis. This simply means that the inflammation involves the synovium and tendons that control the movement of the thumb.

Sometimes the problem is called de Quervain's tendinosis, de Quervain's disease, texting thumb, gamer's thumb, or new mother's thumb.

Who Gets It

DeQuervain's tenosynovitis is most common in the 30-50 year old age group and is seen more commonly in women. It can be associated with pregnancy and rheumatoid disease. DeQuervain's tenosynovitis is due to excessive use of the wrist. It is commonly seen in new mothers as the motion of picking up the baby can cause irritation to these wrist tendons. It can also be seen in people who use a hammer often, gardeners, skiers and people who play racquet sports. It may also occur in people who overuse their thumbs in texting and gaming.

Signs of de Quervain's

The main symptom of de Quervain's tenosynovitis is pain on the thumb side of the wrist, and the pain can radiate up the forearm.The pain can come on all at once or gradually. You will usually feel it worse when you are using your thumb when grasping something or when you are twisting your wrist.

You may also feel a catch when you try to move your thumb. The thumb side of your wrist may be swollen and this may make it more difficult to move it.

The examination of deQuervain's is usually quite typical with tenderness over the involved tendons. These are the tendons of the extensor pollicis brevis and the abductor pollicis longus muscles.

One specific maneuver called Finkelstein's test is quite specific for this condition. Finkelstein's test is performed by making a fist over your bent thumb, and moving the wrist towards the small finger. Patients with deQuervain's tenosynovitis will have pain with this maneuver.

Treatment of de Quervain's Tenosynovitis

Most patients with de Quervain's tenosynovitis will find improvement with wrist splinting and a cortisone injection. The splint is worn continuously, day and night for four to six weeks, to support the thumb and wrist. You also may take anti-inflammatory medications and apply an ice pack to reduce the inflammation. Rest the thumb and wrist and avoid doing the things that cause pain in the tendons.

If the problem persists, a surgical procedure to create more room for the tendons can be performed. During this surgical procedure, the tight tissue around the tendons is cut to release the restriction on tendon motion. Surgery is usually done under local anesthesia but can be performed under regional, or general anesthesia.

If there are any small cysts or inflamed tissue found they may be removed. After surgery, a splint is worn for a few weeks, and normal activities can be gradually resumed. You will be given range of motion exercises to restore your functionality.

Complications of wrist surgery include infection and healing problems.  A small nerve, called the sensory branch of the radial nerve, can be damaged leading to a patch of numbness on the back of the thumb.  One of the more concerning complications is that the tendons can become unstable, snapping out of their normal location on the side of the wrist, after the tendon sheath of the wrist is released.  This problem can be prevented by ensuring the tendon sheath is opened in the proper location, and by limiting specific wrist movements after surgery.


Ilyas AM "de Quervain Tenosynovitis of the Wrist" J. Am. Acad. Ortho. Surg., December 2007; 15: 757 - 764.

De Quervain's Tendinosis, American Academy of Orthopaedic Surgeons, December, 2013.

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