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De Quervain’s Tenosynovitis

Pain on the thumb side of the wrist, worse lifting a kettle or a baby, has a specific diagnosis and responds well.

Overview

What It Is

De Quervain’s affects the two tendons that run along the thumb side of the wrist and their surrounding sheath. It produces sharp, well-localised pain over the bony prominence at the base of the thumb, worse with gripping, lifting and any movement combining thumb use with wrist deviation. It is particularly common in new parents and in the postnatal period.

Radius Ulna

Tap a structure, or use the buttons, to see what may be involved.

The diagnosis

Where It Hurts

Two tendons running to the thumb become irritated within their sheath, producing sharp pain over the bony prominence on the thumb side of the wrist.

Symptoms

How It Tends to Feel

These are the features that point towards this diagnosis rather than another:

Pain Over the Radial Wrist

Localised to the bony prominence at the thumb side.

Worse Lifting

Kettles, saucepans and, characteristically, picking up a baby.

Pain on Thumb Movement

Particularly moving the thumb away from the hand.

Swelling

Sometimes a visible or palpable thickening over the tendons.

Catching or Creaking

A grating sensation with thumb movement in some cases.

Weak Grip

Usually from pain rather than genuine weakness.

Causes & Risk Factors

What Drives It

The usual contributors, in rough order of how often they turn out to matter:

01

Repetitive Thumb and Wrist Use

Lifting, wringing, gripping and repetitive device use.

02

Postnatal Period

Very common, driven by repeated lifting and hormonal changes.

03

Sudden Increase in Load

A new job, hobby or caring role.

04

Anatomical Variation

A separate compartment for one tendon makes it more likely and less responsive.

How We Can Help You

Treatment & Management

Treatment is built around what the assessment finds, but generally follows this shape:

Load Modification: Changing lifting technique — scooping rather than gripping — often helps immediately.
Splinting: A thumb spica splint, particularly at night, is well supported in the early phase.
Progressive Loading: Graded strengthening once irritability settles, which is what prevents recurrence.
Manual Therapy: Soft tissue work and mobilisation of the adjacent wrist joints.
Corticosteroid Injection: Effective where conservative measures have not settled it, and worth discussing.

When to Seek Help

Red Flags — Don’t Ignore These

Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:

⚠ Seek Medical Advice If You Notice

  • Marked swelling with redness and heat
  • Fever alongside a swollen, painful wrist
  • Numbness or pins and needles in the hand
  • Pain following a fall, where a scaphoid fracture needs excluding

If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.

Common Questions

Frequently Asked Questions

Why did this start after having a baby?

Repeated lifting under the arms with the thumbs extended loads these tendons heavily, and hormonal changes affect tendon tissue. It is one of the most common postnatal musculoskeletal problems.

Should I wear a splint all the time?

Not indefinitely. A splint helps during the irritable phase, particularly overnight, but prolonged use costs strength. It is a bridge, not a treatment.

How long does it take?

Typically six to twelve weeks with appropriate load management, sometimes longer in the postnatal period where the provoking activity cannot be avoided.

Not Sure If This Is What You Have?

An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.

Book Your Initial Assessment

This page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.