De Quervain’s Tenosynovitis

De Quervain’s Tenosynovitis is inflammation of the tendons that straighten and move the thumb (abductor pollicis longus and extensor pollicis brevis) where they pass through a tight sheath at the wrist. It causes pain on the thumb side of the wrist, especially with gripping, lifting a child, or twisting jars and keys.

At The New Foscote Hospital, you can access rapid consultant orthopaedic or hand surgeon assessment, targeted imaging, and a full range of non-surgical and surgical treatments to relieve pain and restore function.

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Symptoms

• Pain and tenderness along the thumb-side (radial) wrist
• Pain with pinch, grip, lifting or twisting movements
• Swelling or a firm “thickened” area over the tendon sheath
• Finkelstein’s test (tucking the thumb and ulnar-deviating the wrist) provokes pain
• Occasionally catching or crepitus with tendon movement

Seek specialist advice if pain persists beyond a few weeks or interferes with work, sport or caring duties.

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Causes And Risk Factors

• Repetitive or forceful thumb/wrist use (lifting infants, manual work, racket/club sports)
• Sudden increase in activity or new parenting tasks
• Previous wrist injury or arthritis at the base of the thumb
• More common in women and during the post-partum period

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Diagnosis At The New Foscote Hospital

Diagnosis is primarily clinical. Your consultant may arrange:

• Ultrasound to assess tendon sheath thickening and guide injections
• X-ray if base-of-thumb (CMC) arthritis is suspected
• MRI in atypical or persistent cases

Orthopaedic Services
Meet Our Consultants
Imaging At Foscote (MRI)

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Treatment Options

Non-Surgical Care (first-line)

• Activity modification and ergonomic advice
• Thumb spica splint to rest the tendons
• Topical or oral anti-inflammatories (if appropriate)
• Targeted hand therapy: tendon-gliding, soft-tissue work, graded loading

Corticosteroid Injection

• Ultrasound-guided steroid injection into the tendon sheath can give rapid pain relief in many patients. A second injection may be considered if symptoms recur.

Surgical Treatment (for persistent or recurrent symptoms)

• De Quervain’s release (day-case): opening the tight sheath to allow the tendons to glide freely; sub-sheaths are protected to prevent tendon subluxation.
• Local anaesthetic ± sedation; a small incision at the radial wrist; early hand therapy follows.

Your surgeon will explain expected outcomes, risks (including scar tenderness, nerve irritation, or tendon subluxation), and recovery timelines.

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Recovery And Rehabilitation

• Most people return to light activities within 1–2 weeks after surgery; full strength often returns over 4–6 weeks, guided by your surgeon and therapist.
• Hand therapy focuses on range of motion, scar care, progressive strengthening and a graded return to work/sport or childcare tasks.

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When To Seek Specialist Help

Book a consultation if you have:

• Persistent thumb-side wrist pain despite rest and splinting
• Pain that wakes you or limits daily tasks and childcare
• Recurring symptoms after an initial improvement
• Concerns about returning safely to sport or manual work

Early assessment speeds recovery and reduces the risk of chronic pain.