At a glance
Main symptoms
- Pain at the thumb base and radial wrist
- Marked worsening with holding babies, opening jars, lifting heavy objects
- Sometimes swelling and tenderness in the painful area
- Hospital stay
- No hospital stay required, same-day discharge.
- Recovery time
- 4–6 weeks
- Return to work
- Return to desk work in 3-7 days, light hand-use work in 2-3 weeks, heavy hand work in 4-6 weeks.
De Quervain tendinitis is inflammation of the shared sheath of two thumb tendons (APL and EPB). Friction inside the sheath disrupts tendon gliding and causes pain. It is most common in women aged 30-50, particularly in new mothers ("mother's tendinitis"), those performing repetitive thumb movements, and recently in heavy smartphone users.
Symptoms
Classic complaints include:
- Pain at the thumb base and radial wrist
- Marked worsening with holding babies, opening jars, lifting heavy objects
- Sometimes swelling and tenderness in the painful area
- Sharp pain when bending or extending the thumb
- Pain may radiate up the forearm
Diagnostic Methods
The Finkelstein test is classic for diagnosis: the thumb is folded into the palm and the wrist is bent toward the little finger side. This maneuver produces sharp pain in De Quervain tendinitis. Clinical examination is usually sufficient for diagnosis; imaging is used for unclear cases or to exclude comorbid pathology.
Treatment Approach
Non-Surgical Treatments
First-line treatment is always non-surgical and successful in the vast majority of cases. Treatment includes: thumb spica splint (3-6 weeks), activity modification, NSAIDs, physical therapy, and when needed, cortisone injection into the tendon sheath. The injection provides lasting relief in 70-80% of cases.
Surgical Treatment
Surgery is considered for cases unresponsive to conservative treatment or not healed in 6 months. A small operation called De Quervain decompression opens the narrowed sheath and releases the tendons. The procedure takes 15-20 minutes and is usually done under local anesthesia.
Surgical Process
Under local or regional anesthesia, a 2-3 cm incision is made on the radial side of the wrist. The narrowed sheath is split and tendons released. Procedure lasts 15-30 minutes.
Hospital Stay
No hospital stay required, same-day discharge.
Recovery Process
- Week 1: Splint use, gentle finger movements allowed
- Weeks 1-2: Suture removal, splint use reduced
- Weeks 2-4: Active range-of-motion exercises, physical therapy
- Weeks 4-6: Return to full activity, gripping exercises
Return to Work
Return to desk work in 3-7 days, light hand-use work in 2-3 weeks, heavy hand work in 4-6 weeks.
Potential Complications
Surgery is quite safe. Rare complications include temporary sensory changes in the superficial branches of the radial sensory nerve, tendon subluxation, and wound healing problems.
Frequently asked questions
How many times can cortisone be injected?
Generally no more than 2-3 injections to the same area. If the first injection is insufficient, a second dose may be tried after 6 weeks; for a third dose, surgery is prioritized.
Can I hold my baby while wearing a splint?
The splint immobilizes the thumb but allows palm use. In the first weeks, getting help when holding the baby will speed recovery.
Is there a risk of recurrence?
Recurrence after surgery is very rare (less than 1%). Conservative recovery may recur if the same activity continues; activity modification is important.
This content is for information only and does not replace examination, diagnosis or treatment. The right treatment for you is decided after an examination.