De Quervain's Tenosynovitis

Common Upper Limb & Hand Conditions De Quervain's Tenosynovitis

De Quervain tenosynovitis is one of the most common and painful conditions of the wrist. This condition affects the thumb side of the wrist and creates immense pain with movements of the wrist and when straightening the thumb back, e.g. when picking up a child under their arms. This is due to a complicated pathological process that is poorly understood, called degenerative or myxoid degeneration. In De Quervain tenosynovitis, the wall of the tunnel that contains the short extensor tendon and long abductor tendon of the thumb becomes thickened.

This means that there is less space for the two tendons in the sheath, causing a significant amount of friction on the tendons, which causes classic inflammatory swelling, pain and disuse symptoms. As the process progresses, with further thickening of the tendons and the wall, the tendons become entrapped in such a way that it becomes unbearable to move the thumb or the wrist. The radial nerve is also irritated by this mechanical restriction, resulting in painful neuralgic symptoms down the thumb and index finger.

De Quervain tenosynovitis is more common in females, especially during and after pregnancy. The pain is very specific on the radial side of the wrist (where the thumb is), where pinching, repetitive gripping and twisting movements of the thumb become excruciating.


Initially, the treatment of De Quervain tenosynovitis, in the early stages, is to avoid the movements that cause discomfort through rest or splinting. However, by the time most patients present, the pathology is fairly advanced. A cortisone injection could be considered in the early phases, as this is believed to reduce the volume and inflammation in the tunnel, and this may give temporary relief from symptoms. In advanced cases, a surgical release is done, releasing the tunnel and freeing up the tendons, ensuring that a better range of motion is achieved.

Please feel free to contact us if you are struggling with this very disabling condition. The surgical outcome, generally, has excellent results.

It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.