Patient Education

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De Quervain’s Tendonitis

De Quervain’s Tendonitis is inflammation or swelling of the tendons that control movement of the thumb. Specifically, it affects the abductor pollicis longus and extensor pollicis brevis tendons that run along the thumb side of the wrist. The swollen tendons rub against the narrow tunnel (sheath) they pass through, causing pain, swelling, and difficulty moving the thumb.

Common Symptoms

Pain or tenderness at the base of the thumb and wrist which may radiate up the forearm is the main symptom. There is often swelling near the base of the thumb.

Cause & Anatomy

The most common cause is repetitive hand and wrist motions, such as wringing out a cloth, grasping tools, or lifting a baby. Other causes include direct injury to the wrist or tendons, inflammatory conditions like rheumatoid arthritis, and fluid retention during pregnancy. Risk factors include age (30-50 years old), female gender, pregnancy, jobs/hobbies involving repetitive wrist motions.

The important anatomy involved in De Quervain’s Tendonitis is the first dorsal compartment of the wrist, which contains the tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles. A nerve sits on top of this area and may be irritated causing electrical shocks or pain.


Physical examination:
The doctor will examine the wrist and thumb area, applying pressure to check for tenderness and swelling around the base of the thumb.

Finkelstein test:
This is the primary diagnostic test for De Quervain’s tendonitis. The patient makes a fist with the fingers closed over the thumb, then bends the wrist towards the little finger. This maneuver puts tension on the affected tendons. If the patient experiences pain near the base of the thumb during this test, it indicates De Quervain’s tendonitis.


The key is to avoid overusing the tendons in the wrist and thumb through repetitive motions or awkward positioning that can lead to inflammation and irritation of the tendon sheaths. Adjusting to reduce strain on this area can help prevent de Quervain’s tendonitis from developing.


Splints: A removable splint that keeps the wrist straight and the thumb immobilized can help reduce pain and swelling, especially when worn at night.

Non-steroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen and naproxen, taken orally or applied topically, can help reduce inflammation and relieve pain.

Activity modification: Avoiding activities that cause pain and swelling may allow the symptoms to resolve on their own.

Corticosteroid injections: An injection of corticosteroids into the tendon sheath can effectively reduce swelling and pain. One or two injections can relieve symptoms in 50-80% of patients.

Physical therapy: A therapist can teach exercises to strengthen the muscles and reduce tendon irritation.


The surgeon makes a small incision at the base of the thumb and locates the extensor retinaculum, which is the band of fascia that runs across the top of the tendons.

The surgeon then releases the extensor retinaculum or tunnel holding the tendons. This allows the tendons to glide freely through the tunnel. The incision is closed with stitches and the area is bandaged.


Ice therapy, elevation, and pain medication are used to manage pain and swelling in the first few days. Light use of the fingers is allowed, but no heavy gripping, lifting over 1 lb, or strenuous activities for 2 weeks. Most patients regain full use of the hand, with complete range of motion and strength, within 4-6 weeks after surgery.


What if I suspect I have De Quervain’s Tendonitis?
Seek an evaluation from a hand surgeon as soon as possible.

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