DeQuervain’s Tenosynovitis

DeQuervain’s Tenosynovitis is an inflammation of the sheath protecting the tendons of your thumb, this leads to stiffness, swelling and pain. The purpose of this blog is for you to understand what deQuervain’s is and the best way of managing this.

As mentioned above, deQuervain’s is an inflammation of the sheath of the extensor pollicis brevis and the abductor pollicis longus tendons. Extensor pollicis brevis has the job of extending (bending back) the thumb whilst the abductor pollicis longus is responsible for abducting (moving away) the thumb.

There are many causes of deQuervain’s tenosynovitis however most commonly this is due to overload or repetitive strain to the tendons of the thumb. The tendon can be overloaded by repetitive lifting / gripping or direct impact to the tendon. However, the most common presentation of deQuervain’s is in young mothers following repetitive holding of their newborn, especially while breastfeeding or attempting to settle the baby.

The symptoms of deQuervain’s include pain, swelling and stiffness around the thumb and thumb side of the wrist. After a thorough subjective assessment of your wrist and thumb pain, our skilled physiotherapists will perform some simple range of motion, strength and palpation of your thumb. There is a very reliable test of determining if you do in fact have deQuervain’s, this is called the Finkelstein test. It requires the physiotherapist to stretch your tendons, if positive and your pain is reproduced it is likely that you have deQuervain’s.

Initial management of deQuervain’s is to reduce pain and inflammation. Generally, this is done by soft tissue release to the muscles of the responsible thumb tendons. Like other tendon injuries it is critical that loading exercises are performed. This will ensure that your thumb adapts and is able to meet the load that you apply consistently through those tendons. Some of the other strategies that can be helpful in the management of this painful condition is ice on the affected area as well as strapping the thumb to avoid the provocative load (only in the short term).

Most cases of deQuervain’s settle well with hands on physiotherapy treatment however some are quite stubborn and may require medical intervention. Our team of Physiotherapist’s liaise frequently with the best sports medicine experts and general practitioners in Perth and will refer you on to see one of them if we see fit. They may be able to prescribe some short term anti inflammatories or an injection which will help you load your tendon better. It is important to realise before going down this path that anti-inflammatory interventions will not fix you but may temporarily ease your pain.

If you or anyone you know is suffering from recent or persistent thumb pain, please do not hesitate to contact us directly. We would be more than happy to help in the recovery of your thumb pain.


Article written by Matt Beavis