De Quervain’s Tenosynovitis: Symptoms, Risk Factors and Treatment

De Quervain’s tenosynovitis is one of the most common tendon swelling conditions. It involves painful swelling of the thumb and wrist tendons. Today, we’ll cover the causes and symptoms of de Quervain’s tenosynovitis, what to do if you think you have this condition, and when to see a physical therapist. Plus, learn how to reduce the likelihood of developing de Quervain’s tenosynovitis in the future. 

What is de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) is an inflammation, or swelling, of the tendons on the thumb side of the wrist – the tendons that connect the wrist to the bottom of the thumb. This condition is also called de Quervain’s tendinitis or de Quervain’s tendinosis.

Sometimes, de Quervain’s tenosynovitis is colloquially called “mommy thumb” (because many people with de Quervain’s tenosynovitis are moms of babies and young children) or “gamer’s thumb” (because repeated use of the thumbs during video games can cause the tendons to swell).

What are the symptoms of de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis causes pain in the wrist, especially on the thumb side of the wrist. It can also cause pain within the thumb itself, as well as the forearm on the thumb side. The pain can either start suddenly or build gradually. 

If you have this condition, you might notice that your thumb swells up, or you might have difficulty moving your thumb and wrist. You might also feel a “popping” or “snapping” in your wrist when you move your thumb, or a “sticking” sensation in the thumb.

You’ll probably notice the pain the most when you try to move your thumb, grasp or pinch something, turn your wrist, make a fist, or lift a child or object with your arms in front of you and your thumbs pointed up. Pain from De Quervain’s tenosynovitis usually feels worse when you use your thumb. 

What happens in the body when someone has de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a swelling of the tendons that connect the thumb and wrist. 

The tendons are ropelike tissues that connect bones to muscles, and that let the muscles move the bones. You have two tendons on the thumb side of each wrist: one that helps you move your thumb away from your index finger, and one that helps you straighten the thumb joints. Each tendon is covered by a sheath of tissue that keeps the tendon in place. 

Usually, tendons slide smoothly through the sheaths of tissue. But if the tendon or sheath gets inflamed, this creates friction. The tendon can’t slide through the sheath smoothly, leading to pain and difficulty moving the thumb and the wrist where the tendons are inflamed. 

What causes de Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is usually caused by one of the following:

• Overuse of the thumb and/or wrist (which causes the tendons to become inflamed)
• Repeated strain on the thumb and/or wrist
• This commonly results if you repeatedly lift a child by straddling their armpits between your thumbs and index fingers, or repeatedly lift heavy grocery bags by the handles.
• Gaming, texting, gardening, hammering, skiing, swinging a golf club, playing tennis, and playing other racquet sports can also lead to or aggravate de Quervain’s tenosynovitis
• Direct injury to the thumb, wrist, or tendon
• Inflammatory conditions, including arthritis

Risk factors for de Quervain’s tenosynovitis

You are more likely to develop de Quervain’s tenosynovitis if you:

• Are a woman: Women are more likely to develop de Quervain’s tenosynovitis than men. Some experts estimate that women are 8 to 10 times more likely to develop this condition.
• Are between the ages of 30 and 50: People in this age range are at a higher risk of de Quervain’s tenosynovitis. 
• Commonly do an activity that involves repeated wrist or thumb movements, like tennis, gardening, skiing, golf, or playing video games.
• Are pregnant: Pregnancy is often associated with de Quervain’s tenosynovitis, possibly due to inflammation associated with hormones.
• Are caring for a young child: Lifting a baby or young child, especially by picking them up from under the arms, can aggravate the tendons. Moms of babies make up the majority of people with de Quervain’s tenosynovitis, but dads of young children are also at risk for de Quervain’s tenosynovitis if they lift their child often. 
• Are breastfeeding: Certain breastfeeding positions, such as the football hold, can also strain the tendons.

What should you do if you think you have de Quervain’s tenosynovitis?

If you think you have de Quervain’s tenosynovitis, limit any activities that could strain the thumb and wrist. This means limiting texting and typing on your smartphone. Also, regularly apply ice to your thumb and wrist.  And if you have a young child, you should have someone else in your house lift and carry your child as much as possible.

If symptoms don’t improve after trying these steps, you should consult a physical therapist. 

De Quervain’s tenosynovitis needs treatment to resolve, whether that’s rest on your own or guidance from a physical therapist. Most cases of de Quervain’s tenosynovitis resolve with non-surgical treatment, including the treatment provided by a physical therapist. But in rare cases, you may need surgery to treat de Quervain’s tenosynovitis. 

Physical therapy for de Quervain’s tenosynovitis

A physical therapist will help you determine the cause of your thumb or wrist pain, and rule out other conditions that cause similar symptoms. Most of the time, a physical therapist can diagnose de Quervain’s tenosynovitis relatively quickly. They’ll usually ask for a list of activities that you do frequently that could be straining the thumb or wrist, so come prepared with a list. They’ll also ask if you recently had a thumb injury or wrist injury, or if any movements, tasks, or hobbies are causing thumb or wrist pain. 

Your physical therapist will often conduct a test known as the Finkelstein test, where you place your thumb inside your palm, put your other fingers over your thumb, and bend your wrist towards your little finger. If you experience pain when going through these steps, this indicates that you likely have de Quervain’s tenosynovitis. 

Once they’ve determined the cause of your pain, a physical therapist will prescribe treatments and exercises to reduce the inflammation, relieve the pain, and help you regain a wider range of thumb and wrist motion. They’ll also recommend ways to reduce thumb and wrist strain. 

Sometimes, a physical therapist will recommend anti-inflammatory medication or corticosteroid injections. They might also have you wear a thumb spica splint for a few weeks. The splint will restrict thumb movement and rest the thumb and wrist, to let the tendons rest and heal. 

Trust PeteHealth for de Quervain’s tenosynovitis treatment

Looking for a physical therapist you can see from anywhere, on your schedule? PeteHealth is the trusted physical therapy solution that works for you, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

PeteHealth makes tailored care even easier for patients with PeteDME, which offers custom fit durable medical equipment (DME) prescribed by your PeteHealth PT to address your unique needs. 

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth and PeteDME. 

How to help prevent future de Quervain’s tenosynovitis?

After you’ve recovered from de Quervain’s tenosynovitis, you can reduce the likelihood of developing it in the future with the following tips:

• Follow your physical therapist’s advice on which activities you should limit and which activities you should avoid. 
• Take frequent breaks from tendon-straining activities like texting, gaming, gardening, and hammering.  
• If you have a baby or young child, pick them up by placing one hand on their bottom and the other hand on their neck or back, keeping your palm up. This method of picking up a child is much less straining on the tendons. 

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