De Quervain’s Tenosynovitis

What is it?

De Quervain’s tenosynovitis. This is the technical name for wrist pain near your thumb due to the sheath around the thumb’s tendons becoming irritated. It is a common condition for:

• New parents or guardians of infants
• Office workers
• Jigsaw puzzle enthusiasts

How did I get it?

De Quervain’s is an overuse injury. The condition is brought on by sudden increases in performing wrist activities or from repetitive wrist movements. Examples include:

• Lifting a newborn baby
• Transitioning to a desk-based job with lots of mouse work
• High repetitions of turning or flipping objects

What do I need to do?

Given that De Quervain’s is a tendon-based injury, the best immediate course of action is to “de-load” the area. This means to reduce the performance of aggravating action(s).

It is impractical to tell a parent or guardian to stop lifting their little one entirely. When De Quervain’s is brought on from caring for babies, we recommend modifying your method of lifting. Instead of placing your hands on either side of your babe’s torso, pop one hand between their legs and under their back with the other hand on their tummy. Using this “sandwich lifting technique”, there will be little wrist or thumb movement in the aggravating direction.

Soft tissue work such as self-massaging through your forearm will help to de-load the tendon and relieve symptoms.

Symptoms can also be alleviated by taping the wrist and thumb to restrict the painful movements or in some cases a brace is considered.

How do I keep it away?

It is important to keep in mind that tendons respond to load. The condition came on due to over-loading, symptoms are alleviated through de-loading, thus to keep symptoms away we must re-load the area. Re-loading must be gradual. Gradual re-loading prevents doing too much too soon which results in over-loading.

Re-loading includes strengthening exercises such as wrist curls and hammer twists. For appropriate resistance and dosage prescription for you, be sure to consult your local physiotherapist.

Other considerations

You may have heard of some folks finding symptom relief for their De Quervain’s diagnosis with a cortisone injection. This is possible, however, cortisone does not address the underlying cause of why your symptoms occurred so your pain can come back after an injection. Cortisone also doesn’t work for everyone so you may still have pain despite having an injection. Additionally, cortisone degrades tendon health; this makes you prone to re-occurrence of symptoms later in life or worsens your initial episode of symptoms.