DeQuervain’s Tenosynovitis refers to the swelling of the synovial sheath which surrounds tendons of the thumb, specifically the Abductor Pollicis Longus (APL) and the Extensor Pollicis Brevis (EPB) tendons.
Presentation:
This condition presents as pain and/or tenderness along the thumb side of the wrist. This pain may or may not travel up along the forearm as well and may be present when moving the thumb, wrist, or when gripping. Swelling along the thumb side of the wrist can also be present.
Cause:
DeQuervain’s is typically caused by repetitive motion or use of the thumb or forceful gripping while deviating the wrist towards the pinky side of the hand. As a result of chronic, repetitive microtrauma the sheath or synovium that surrounds the Abductor Pollicis Longus (APL) as well as the Extensor Pollicis Brevis (EPB) tendons becomes inflamed and thickened. The APL and EPB are tendons which are responsible for moving the thumb into abduction (away from the midline of the body) as well as extension (moving the thumb back, away from the palm side of the hand). DeQuervain’s Tenosynovitis is more common in women, especially following pregnancy, and in individuals with arthritis.
How We Can Help:
A musculoskeletal provider can aid in helping you diagnose this condition as well as help to decrease the symptoms and reach complete improvement. We can help identify activities which are aggravating this complaint, aid in modifying such activities, recommend rehabilitative exercises which will aim to strengthen the musculature surrounding the thumb and wrist, recommend the potential use of a splint if needed, as well as provide anti-inflammatory mechanisms which have been shown to be effective at treating DeQuervain’s Tenosynovitis.
About the author
Dr. Eric Dickerson, DC, FRCms
Founder, Sports Chiropractor
As the Founder and Director of Clinical Development at Radius Physical + Sports Rehab, Dr. Eric Dickerson is a dedicated musculoskeletal provider who blends clinical experience with a patient-centered approach. He integrates functional rehabilitation, evidence-based physical rehabilitation modalities, joint manipulation, and advanced manual therapy techniques to craft a comprehensive approach to your health.
More from Dr. Eric Dickerson →Frequently Asked Questions
Common questions about de Quervain's tenosynovitis.
What is de Quervain's tenosynovitis?
De Quervain's tenosynovitis is a painful condition affecting the first dorsal compartment of the wrist, where two thumb tendons — the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) — run along the thumb side of the wrist. The tendon sheath thickens and undergoes myxoid degeneration, so the tendons no longer glide smoothly, producing pain around the base of the thumb.
What does de Quervain's tenosynovitis feel like?
The main symptom is pain on the thumb (radial) side of the wrist, typically worsened by thumb and wrist movement. Pain can radiate into the thumb or up the forearm and often flares with gripping, pinching, or twisting motions such as opening a jar lid. People may also notice swelling, stiffness, a snapping sensation, or tenderness over the bony bump at the wrist (the radial styloid).
What causes de Quervain's tenosynovitis, and who is most at risk?
It is usually linked to repetitive wrist and thumb movements — especially those combining thumb motion with side-to-side wrist deviation — and to chronic overuse from work or hobbies. Women are affected far more often than men, and pregnancy and repeatedly lifting young children are significant risk factors. It is most common in people in their forties and fifties, and inflammatory conditions can also contribute.
Why is de Quervain's sometimes called "mommy thumb"?
De Quervain's is nicknamed "mommy thumb" because a classic patient is a pregnant woman in the third trimester or a breastfeeding mother, and repeatedly lifting a young child is a recognized risk factor. Hormonal changes around pregnancy may also contribute, which helps explain why new parents and childcare workers develop it. Men and non-parents can get it too, usually from other repetitive thumb and wrist activities.
How is de Quervain's tenosynovitis treated without surgery?
Most patients are treated successfully without surgery. Common conservative options include a splint or brace to rest the thumb and wrist, avoiding repetitive or side-to-side wrist motions, ice, anti-inflammatory medication, and physical therapy with activity modification, range-of-motion work, and strengthening. Corticosteroid injections are also frequently used; reported figures suggest roughly 50% of patients get relief from a single injection, with a second injection helping another 40% to 45%.
When is surgery needed for de Quervain's, and what does it involve?
Surgery is generally considered only when symptoms are severe or do not improve with nonsurgical care — one source cites failure to improve after about 6 weeks of nonsurgical treatment, and another cites recurrence after two corticosteroid injections. The procedure releases the tendon sheath to make more room for the irritated tendons. Most patients who have surgery improve, and complications are rare, though people with diabetes may face higher complication rates.
How can I lower my risk of de Quervain's tenosynovitis?
You can reduce risk by avoiding chronic overuse and forceful, repetitive thumb and wrist movements. When an activity must be repeated, taking frequent breaks and modifying how you grip, lift, or position the wrist can help ease load on the thumb tendons. For new parents, this often means varying how a child is lifted so the wrist is not repeatedly bent to the side under load.
When should I see a clinician about thumb-side wrist pain?
It is reasonable to seek care as soon as you notice ongoing pain, swelling, or other symptoms on the thumb side of the wrist, particularly if pain worsens with gripping or thumb movement or does not settle with rest. A clinician can confirm the diagnosis — often using the Finkelstein test, in which the wrist is bent toward the little-finger side and reproduces sharp radial-sided pain — and rule out other causes.
The information on this website is general education about musculoskeletal and movement-related conditions. It is not medical advice or a diagnosis, and it cannot tell you what is causing your symptoms. Reading it is not a substitute for an in-person evaluation, and booking a visit does not confirm that your condition is right for our care until a provider has examined you. This information cannot identify every condition, and some urgent problems can feel like musculoskeletal pain. If your symptoms are severe or getting worse, or you are unsure how urgent they are, contact your physician, call 911, or go to the nearest emergency room. When in doubt, seek emergency care.
