A common overuse injury that affects the tendons which run along the outside of your thumb.

What is De Quervain’s tenosynovitis?

When the sheath surrounding the two tendons controlling thumb movement becomes inflamed, this is called de Quervain’s tenosynovitis.

The tendons run from the wrist to the thumb. During muscle contraction such as gripping, tension is placed on the respective tendons and the tendons may rub against the bony prominence found on the part of the wrist where the thumb is; when these forces are excessive, damage to the tendons may occur resulting in De Quervain’s tenosynovitis.

What causes De Quervain’s tenosynovitis?

Repetitive or sustained activities that place strain on the tendons on the outer/back aspect of the hand can cause de Quervain’s tenosynovitis. These activities can include sports such as: golf, bowling, racquet sports, coning and rowing or manual work including bricklaying, painting and carpentry.

It is usual for you to develop this condition after a sudden increase in activities that place stress on the thumb tendons.

Occasionally it may develop suddenly due to a direct blow to the back of the thumb.

What symptoms does someone with De Quervain’s tenosynovitis present with?

De Quervain’s tenosynovitis symptoms usually develop slowly over time and at first they may develop as an ache or stiffness in the thumb or back of wrist after doing unaccustomed or aggravating activities.

Symptoms may be:

  • Swelling over the area
  • Pain when moving the thumb
  • Pins and needles or numbness in the thumb
  • Weakness in the wrist, thumb and hand

How can De Quervain’s tenosynovitis diagnosed?

Your physiotherapist can diagnose De Quervain’s tenosynovitis by carrying out a full subjective and objective examination.

A test called Finkelstein’s test can also diagnose if you have the condition. To do the test you place your thumb in the palm of your hand, make a first around it, and bend your wrist in the direction of your little finger- if this makes the pain worse than that is considered a positive test for De Quervain’s tenosynovitis.

What treatment can Farrell Physiotherapy offer for De Quervain’s tenosynovitis?

  • Apply ‘RICE’ principle initially
  • Soft tissue massage
  • Thumb bracing/splinting
  • Electrotherapy
  • Joint mobilisation
  • Ice/heat therapy
  • Advice and education
  • Flexibility and strength exercises
  • Dry needling
  • Activity/sporting modification advice
  • Sporting technique correction
  • Graded return to activity plan
  • Anti-inflammatory advice

In rare cases, conservative treatment may not be effective and surgery is required. Physiotherapy is also beneficial post-surgery to ensure full range of movement and strength is maintained post-op.

Benefit of physiotherapy for De Quervain’s tenosynovitis?

Physiotherapy treatment can provide great results and our aim is to get you symptom free as quickly as possible. The benefits you receive from physiotherapy will depend on your initial symptoms and goals.

Physiotherapy aims to:

  • Restore function
  • Reduce pain
  • Prevent re-injury occurring
  • Improve flexibility and range of movement

If you would like to book an assessment or enquire further, please call 01245 615 051 or e-mail: infofarrellphysiotherapy@gmail.com.