In short
De Quervain’s tenosynovitis is pain and swelling on the thumb side of the wrist, where two thumb tendons run through a tight tunnel. It hurts to grip, pinch, twist or lift with the thumb out. It is most common in women, in people over 40 and in new parents. A splint and changing how you lift help mild cases. An injection combined with a short spell in a splint is the most effective treatment, and a small operation fixes the cases that don’t settle.
On this page
What is de Quervain’s tenosynovitis?
Two tendons that move your thumb run side by side through a tight tunnel on the thumb side of your wrist. If the roof of that tunnel thickens, the tendons can no longer glide freely, and moving your wrist and thumb becomes painful.1
The condition is also called de Quervain’s disease. Nicknames include “mummy’s thumb” and “texting thumb”.
Symptoms
- Pain on the thumb side of the wrist, which can spread up the forearm or into the thumb
- A tender swelling at the base of the thumb1
- Pain when you grip, pinch, wring out a cloth, turn a key or lift something with your thumb pointing up
- Sometimes a catching or creaking feeling as the thumb moves
A simple test
Tuck your thumb into your palm, close your fingers over it, and gently tilt your wrist towards your little finger. Sharp pain on the thumb side of the wrist suggests de Quervain’s. Doctors usually make the diagnosis from this kind of examination, and an X-ray is needed only to rule out a problem in the bones.2
Pain that keeps coming back?
Talk it through with an Australian doctor online. No referral needed.
Who gets it?
A study of more than 11,000 cases in the American military gives the clearest picture. Women were affected more than four times as often as men, and people over 40 about three times as often as those under 20.3
New parents
De Quervain’s is well known in late pregnancy and in the months after a baby arrives. Lifting a baby again and again with the thumbs spread and the wrists bent loads exactly these tendons, and fluid changes in pregnancy may add to it. This form usually clears up by itself. In a small trial in pregnant and breastfeeding women, most of those treated with a splint alone found their symptoms had gone by the time they stopped breastfeeding.4
Is it caused by work or phone use?
It is often blamed on repetitive hand work. A systematic review found that people doing repetitive, forceful or awkward manual work were about three times as likely to have it, but concluded that the studies weren’t good enough to prove that the work was the cause.5 The same uncertainty applies to phones and gaming. If an activity reliably brings on your pain, though, it makes sense to change how you do it.
Treatment
Rest the tendons and change the movement
- Avoid lifting with your thumbs out and wrists bent. Scoop a baby up with your palms under their bottom and your wrists straight
- Take breaks from repeated pinching, gripping and twisting
- Use the other hand, or both hands, for heavy items
Splint
A splint that holds the wrist and thumb still gives the tendons a rest. For mild symptoms, resting the wrist and thumb, wearing a splint at night and physiotherapy may be enough.1
Injection
An injection into the tunnel at the base of the thumb can settle the problem in up to 8 in 10 people.1 In the trial of pregnant and breastfeeding women, all nine who had an injection got complete pain relief.4
A 2024 analysis of 14 randomised trials concluded that an injection followed by a short period in a splint or cast is the most effective treatment, and appears to work better than an injection alone.6
Surgery
If injections haven’t worked, a small operation can open the roof of the tunnel so the tendons glide freely again. It is usually done under local anaesthetic, takes about half an hour, and you go home the same day. About 8 in 10 people improve quickly. The main risk is numbness or tenderness on the back of the thumb if a small skin nerve is irritated.1
How long does it last?
That depends on the cause. When there is a clear trigger that ends, such as caring for a young baby, it usually settles. When there isn’t, symptoms tend to continue until treated.1
What else could it be?
- Arthritis at the base of the thumb. More common after 50, with aching and grinding in the joint where the thumb meets the wrist
- Carpal tunnel syndrome. Tingling and numbness in the thumb and fingers, often at night. See carpal tunnel syndrome
- A wrist fracture, if the pain began with a fall onto the hand
When to see a doctor
- Thumb or wrist pain that hasn’t improved after a couple of weeks of rest
- Pain that is stopping you from caring for a baby, working or sleeping
- Numbness or tingling in the hand
- Pain that started after a fall
- A wrist that is red, hot and swollen
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Surgery for de Quervain’s disease.
- Ilyas AM, Ast M, Schaffer AA, et al. De quervain tenosynovitis of the wrist. J Am Acad Orthop Surg. 2007;15(12):757-64.
- Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain's tenosynovitis in a young, active population. J Hand Surg Am. 2009;34(1):112-5.
- Avci S, Yilmaz C, Sayli U. Comparison of nonsurgical treatment measures for de Quervain's disease of pregnancy and lactation. J Hand Surg Am. 2002;27(2):322-4.
- Stahl S, Vida D, Meisner C, et al. Systematic review and meta-analysis on the work-related cause of de Quervain tenosynovitis: a critical appraisal of its recognition as an occupational disease. Plast Reconstr Surg. 2013;132(6):1479-1491.
- Chong HH, Pradhan A, Dhingra M, et al. Advancements in de Quervain Tenosynovitis Management: A Comprehensive Network Meta-Analysis. J Hand Surg Am. 2024;49(6):557-569.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.