What is it?
De Quervain’s Tenosynovitis is an inflammation of the tendons on the thumb side of the wrist. It usually affects the tendons of abductor pollicis longus (APL) and extensor pollicis brevis (EPB).
Causes and Risk Factors
Repetitive thumb/wrist movements (typing, texting, lifting, gaming, childcare)
Sudden increase in hand activity
Arthritis patient
Post-pregnancy most common due to hormonal and childcare stress on wrist.
Symptoms
- Pain on the thumb side of wrist (near radial styloid)
- Swelling or tenderness over the tendons
- Pain increases with thumb movement like griping and lifting baby
- Finkelstein’s test -positive – pain when bending thumb into palm and ulnar deviating wrist
Treatment
1.)Conservative / Non-surgical
Rest and activity modification (avoid repetitive thumb/wrist strain)
-Splint (thumb spica splint) for immobilization
-Ice packs for pain/swelling
-NSAIDs (ibuprofen, diclofenac, etc.) for inflammation
-Physiotherapy – stretching & strengthening exercises once pain subsides
Injections
Corticosteroid injection around tendon sheath – often gives significant relief
Surgical (if persistent despite conservative care)
Release of tendon sheath to reduce pressure (minor daycare procedure)
Exercises (after acute pain settles)
- Thumb stretch: Pull thumb gently away from hand
- Wrist radial/ulnar deviation with light weight
- Grip strengthening with soft ball
Go and see your doctor if-
Pain not improving with rest and medication
Difficulty holding or lifting objects
Severe swelling or locking of thumb
This case highlights the successful management of wrist pain through surgery performed by Dr. Aditya Lakhotia, Orthopedic Surgeon in Indore. The patient achieved significant pain relief, improved wrist function, and an enhanced quality of life, demonstrating the effectiveness of timely surgical intervention.