De Quervain Tendinitis; Symptoms, Diagnosis, Treatment

User Review
5 (2 votes)
De Quervain tendinitis is inflammation of two tendons that control the movement of the thumb and their tendon sheath. This results in pain at the outside of the wrist. Pain is typically increased with gripping or rotating the wrist. The thumb may also be difficult to move smoothly. The onset of symptoms is gradual.
De Quervain’s tenosynovitis can be brought on by simple strain injury to the extensor pollicis longus and abductor pollicis tendons (tendinitis). Often this form of tendinitis is a result of repetitive motion injury. Typical causes of de Quervain’s tenosynovitis include stresses such as lifting young children into car seats, lifting heavy grocery bags by the loops, and lifting gardening pots up and into place.
De Quervain’s disease precisely defined as stenosing tenosynovitis of the first dorsal compartment” [], is a common pathological condition of the wrist. Because of thickening of the sheath containing the abductor pollicis longus and extensor pollicis Brevis tendons at the radial styloid process [,], it causes swelling and pain on the radial side of the wrist. Grip strength is gradually lost as the symptoms worsen. A number of non-surgical treatments, such as splinting, anti-inflammatory drugs (NSAIDs), and corticosteroid injections, are used to treat this disease [,]. Like trigger finger and carpal tunnel syndrome, de Quervain’s disease has been considered an overuse syndrome. They are all musculoskeletal disorders caused by repetitive hand posture and motion [].
De Quervain tendinitis

Another Name of De Quervain Tendinitis

TendinopathyDe Quervain tendinitis; de Quervain tenosynovitis

  • A tendon is thick bendable tissue that connects muscle to bone. Two tendons run from the back of your thumb down the side of your wrist. De Quervain tendinitis is caused when these tendons are swollen and irritated.

Anatomy of De Quervain Tendinitis

De Quervain’s tenosynovitis affects two thumb tendons. These tendons are called the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB).

  • Tendons connect muscle to bone. Muscles pull on tendons for movement. The muscles connected to the APL and EPB tendons are on the back of the forearm. The muscles angle toward the thumb.
  • On their way to the thumb, the APL and EPB tendons travel side by side along the inside edge of the wrist. They pass through a tunnel near the end of the radiusbone of the forearm. The tunnel helps hold the tendons in place, like the guide on a fishing pole.
  • This tunnel is lined with a slippery coating called tenosynovium. The tenosynovium is a slippery covering that allows the two tendons to glide easily back and forth as they move the thumb. Inflammation of the tenosynovium and tendon is called tenosynovitis. In de Quervain’s tenosynovitis, the inflammation constricts the movement of the tendons within the tunnel.

Causes of De Quervain Tendinitis

The cause of de Quervain’s tenosynovitis is idiopathic or unknown. However, there are certain risk factors that may increase your chance of developing the condition. These can include the following:

  • Gender – The condition is more common in females than males.
  • Age – It occurs more frequently around ages 30-50.
  • Social Habits – The condition may be caused by overuse such as with frequent texting or typing on mobile devices with your thumbs.
  • Work Habits – Occupations that require repetitive hand and wrist movements such as construction or playing music may increase your risk of developing the condition.
  • Medical Conditions – Patients with diabetes, alcoholism, cirrhosis of the liver, and seizure disorders appear to be at increased risk of developing the condition.
You Can Also Like   Breasts Health; The best health tips for your breasts

Symptoms of De Quervain Tendinitis

  • Pain may be felt over the thumb side of the wrist. This is the main symptoms. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm or down the thumb. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
  • Swelling may be seen over the thumb side of the wrist. This swelling may occur together with a fluid-filled cyst in this region.
  • Pain and tenderness to the thumb base and wrist area near the thumb
  • Swelling to the wrist area near the thumb
  • The fluid-filled cyst may occur at the thumb base
  • Pain may radiate up the arm
  • Pain may occur gradually or suddenly
  • Pain tends to increase with thumb movement
  • Difficulty or inability to grip objects
  • Impaired thumb function affecting daily activities
  • A “catching” or “snapping” sensation may be felt when moving the thumb.
  • Pain and swelling may make it difficult to move the thumb and wrist

Diagnosis of De Quervain Tendinitis

Plain Radiograph

Plain radiographs are non-diagnostic of the condition but may show non-specific signs and can help exclude other causes of pain such as fracture, carpometacarpal arthritis, and osteomyelitis. Signs include:

  • Soft-tissue swelling over the radial styloid
  • Focal abnormalities of the radial styloid including cortical erosion, sclerosis or periosteal reaction


Ultrasound is very often diagnostic. Findings include

  • Oedematous tendon thickening of APL and EPB at the level of radial styloid (compare with a contralateral side)
  • Increased fluid within the first extensor tendon compartment tendon sheath
  • Thickening of overlying retinaculum and the synovial sheath
  • Peritendinous subcutaneous edema resulting in a hypoechoic halo sign
  • Peritendinous subcutaneous hyperemia on Doppler imaging

It is important to assess for an intertendinous septum which can usually be identified if present. Ultrasound is often used to guide corticosteroid injections into the tendon compartment to treat the condition.


  • MRI is very sensitive and specific and useful for detecting mild disease where ultrasound may be equivocal. Presence or absence of intertendinous septum can be assessed. Findings include :


  • Increased fluid within tendon sheath (high T2, low-intermediate T1)
  • Bebris within sheath (intermediate T1 signal)
  • Thickened oedematous retinaculum
  • Peritendinous subcutaneous edema
  • Peritendinous subcutaneous contrast enhancement


  • Tendon enlargement maximal at radial styloid and often greater at the medial aspect of the tendon
  • Slightly increased intratendinous T1 and T2 signal compared to other tendons
  • Striated appearance of tendons due to multiple enlarged slips
  • Longitudinal tendon tear
  • Linear high T2 signal due to the fluid within a split
  • More common in all treatment

Treatment of De Quervain Tendinitis

Conservative Treatment Options

Your surgeon will recommend conservative treatment options to treat your condition if you are experiencing pain and are having difficulty using your hands for everyday activities. Treatment options will vary depending on the severity of the condition. Conservative treatment options may include the following

  • Immobilization – Splints may be applied to rest the affected wrist and thumb and prevent movement until the condition heals.
  • Ice – Applying ice to the affected area over a towel for 20 minutes 3-4xdaily may help with the pain and swelling.
  • Medications – Non-steroidal anti-inflammatory medications (NSAID’s) may be prescribed to decrease the swelling and discomfort.
  • Therapy – Physical therapy may be ordered to reduce the pain & inflammation
You Can Also Like   Melanocytic Tumor, Causes, Symptoms, Treatment


  • Analgesics –  Prescription-strength drugs that relieve pain but not inflammation.
  • Antidepressants –  A Drugs that block pain messages from your brain and boost the effects of endorphins (your body’s natural painkillers).
  • Medication – Common pain remedies such as aspirin, acetaminophen, ibuprofen, and naproxen can offer short-term relief. All are available in low doses without a prescription. Other medications, including muscle relaxants and anti-seizure medications, treat aspects such as muscle spasms and damaged nerves.
  • Corticosteroid injections – Your doctor will inject a steroid such as prednisone into your thumb joints. Steroids make inflammation go down. However, because of side effects, they are used sparingly.
  • Anesthetics – Used with precision, an injection of a “nerve block” can stop the pain for a time.
  • Muscle Relaxants: These medications provide relief from spinal muscle spasms.
  • Neuropathic Agents – Drugs(pregabalin & gabapentin) that address neuropathic—or nerve-related—pain. This includes burning, numbness, and tingling.
  • Opioids –  Also known as narcotics, these medications are intense pain relievers that should only be used under a doctor’s careful supervision.
  • Topical Medications –  These prescription-strength creams, gels, ointments, patches, and sprays help relieve pain and inflammation through the skin.
  • Calcium & vitamin D3 – to improve bones health and healing fracture.
  • Glucosamaine & diacerine – can be used to tightening the loose tenson and regenerate cartilage or inhabit the further degeneration of cartilage.
  • Injections – Corticosteroids injections to the affected tendon sheath may be done to relieve local inflammation and pain

Surgery of De Quervain Tendinitis

If all else fails, you may need surgery. The goal of surgery is to give the tendons more space so they no longer rub on the inside of the tunnel. To do this, the surgeon performs a surgical release of the roof of the tunnel.

  • This surgery can usually be done on an outpatient basis, which means that you won’t have to spend the night in the hospital. It can be done using a general anesthetic, which puts you to sleep, or a regional anesthetic. A regional anesthetic blocks the nerves going to only a certain part of the body. Injection of medications similar to novocaine can block the nerves for several hours.
  • In surgery for de Quervain’s tenosynovitis –  you may get an axillary block, which puts the arm to sleep, or a wrist block, which puts only the hand to sleep. It is even possible to perform the surgery by simply injecting novocaine around the area of the incision.
  • Once you have anesthesia –  your surgeon will make sure the skin of your forearm and wrist is free of infection by cleaning the skin with a germ-killing solution. The first step in the surgical release is to make a small incision along the thumb side of the wrist.
  • The surgeon moves aside other tissues and locates the tendons and the tunnel. An incision is made to split the roof, or top, of the tunnel. This allows the tunnel to open up, creating more space for the tendons. The tunnel will eventually heal closed, but it will be larger than before. Scar tissue will fill the gap where the tunnel was cut.
    The skin is then stitched together, and your hand is wrapped in a bulky dressing.
You Can Also Like   Natural Way to Enlarge, Soft, Attractive Breasts

Post-Operative Care of De Quervain Tendinitis

After surgery, your surgeon will give you guidelines to follow. Common post-operative guidelines include:

  • Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering.
  • Ice packs to the surgical area may be used to reduce pain and swelling.
  • The bandage is usually removed after a couple days.
  • Your surgeon may recommend occupational therapy for strengthening exercises and measures to prevent recurrence.
  • Eating a healthy diet and not smoking will promote healing.

Risks and Complications

As with any major surgery, there are potential risks involved. The majority of patients suffer no complications following tendon release surgery; however, complications can occur and include:

  • Complications from nerve blocks such as infection or nerve damage
  • Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death.
  • Infection
  • Nerve damage causing weakness, paralysis, or loss of feeling in the hand area.
  • Injury to the arteries of the fingers/hand
  • Cond–ition recurs

After Surgery of De Quervain Tendinitis

Rehabilitation is more involved after surgery. Full recovery could take several months. Pain and symptoms generally begin to improve after surgery, but you may have tenderness in the area of the incision for several months.

  • Take time during the day to support your arm with your hand elevated above the level of your heart. You should move your fingers and thumb occasionally during the day. Keep the dressing on your hand until you return to the surgeon. Avoid getting the stitches wet. Your stitches will be removed 10 to 14 days after surgery.
  • You will probably need to attend occupational or physical therapy sessions for six to eight weeks. You’ll begin doing active hand movements and range-of-motion exercises. Therapists also use ice packs, soft-tissue massage, and hands-on stretching to help with the range of motion. When the stitches are removed, you may start carefully strengthening your hand and thumb by squeezing and stretching putty. Therapists also use a series of gentle stretches to encourage the thumb tendons to glide easily within the tunnel.
  • As you progress, your therapist will give you exercises to help strengthen and stabilize the muscles and joints in the hand and thumb. Other exercises are used to improve fine motor control and dexterity. Some of the exercises you’ll do are designed to get your hand working in ways that are similar to your work tasks and sports activities.
  • Your therapist will help you find ways to do your tasks that don’t put too much stress on your thumb and wrist. Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.


De Quervain tendinitis

Print Friendly, PDF & Email

32 thoughts on “De Quervain Tendinitis; Symptoms, Diagnosis, Treatment”

  1. Hello my family member! I wish to say that this article is awesome, nice written and come with almost all important infos.
    I would like to look extra posts like this .

  2. Great post. I used to be checking continuously this blog and I’m impressed!
    Extremely useful info specially the remaining section 🙂 I
    care for such info much. I used to be seeking this certain information for a long time.
    Thanks and best of luck.

  3. It is perfect time to make some plans for the future and
    it is time to be happy. I have learn this submit and if I could I desire to suggest you
    some fascinating things or tips. Perhaps you can write subsequent articles regarding this article.
    I desire to learn more issues approximately it!

  4. Nice blog here! Also your site loads up fast!

    What host are you using? Can I get your affiliate link to your host?
    I wish my site loaded up as fast as yours lol

  5. Hey, how’s it going?

    I want to pass along some very important news that everyone needs to hear!

    In December of 2017, Donald Trump made history by recognizing Jerusalem as the capital of Israel. Why is this big news? Because by this the Jewish people of Israel are now able to press forward in bringing about the Third Temple prophesied in the Bible.

    Jewish Rabbis have publicly announced that their Messiah will be revealed in the coming years who will be a leader and spiritual guide to all nations, gathering all religions under the worship of one God.

    Biblical prophecy tells us that this Jewish Messiah who will take the stage will be the antichrist “who opposes and exalts himself above all that is called God or that is worshiped, so that he sits as God in the temple of God, showing himself that he is God” (2 Thessalonians 2:4). For a time he will bring about a false peace, but “Therefore when you see the ‘abomination of desolation,’ spoken of by Daniel the prophet, standing in the holy place (Matthew 24:15)…then there will be great tribulation, such as has not been since the beginning of the world until this time, no, nor ever shall be” (Matthew 24:21).

    More importantly, the power that runs the world wants to put a RFID microchip in our body making us total slaves to them. This chip matches perfectly with the Mark of the Beast in the Bible, more specifically in Revelation 13:16-18:

    “He causes all, both small and great, rich and poor, free and slave, to receive a mark on their right hand or on their foreheads, and that no one may buy or sell except one who has the mark or the name of the beast, or the number of his name.

    Here is wisdom. Let him who has understanding calculate the number of the beast, for it is the number of a man: His number is 666.”

    Referring to the last days, this could only be speaking of a cashless society, which we have yet to see, but are heading towards. Otherwise, we could still buy or sell without the mark amongst others if physical money was still currency. This Mark couldn’t be spiritual because the word references two different physical locations. If it was spiritual it would just say in the forehead. RFID microchip implant technology will be the future of a one world cashless society containing digital currency. It will be implanted in the right-hand or the forehead, and we cannot buy or sell without it. Revelation 13:11-18 tells us that a false prophet will arise on the world scene doing miracles before men, deceiving them to receive this Mark. Do not be deceived! We must grow strong in Jesus. AT ALL COSTS, DO NOT TAKE IT!

    “Then a third angel followed them, saying with a loud voice, “If anyone worships the beast and his image, and receives his mark on his forehead or on his hand, he himself shall also drink of the wine of the wrath of God, which is poured out full strength into the cup of His indignation. He shall be tormented with fire and brimstone in the presence of the holy angels and in the presence of the Lamb. And the smoke of their torment ascends forever and ever; and they have no rest day or night, who worship the beast and his image, and whoever receives the mark of his name” (Revelation 14:9-11).

    People have been saying the end is coming for many years, but we needed two key things. One, the Third Temple, and two, the technology for a cashless society to fulfill the prophecy of the Mark of the Beast.

    Visit http://WWW.BIBLEFREEDOM.COM to see proof for these things and why the Bible truly is the word of God!

    If you haven’t already, it is time to seek God with all your heart. Jesus loves you more than you could imagine. He wants to have a relationship with you and redeem you from your sins. Turn to Him and repent while there is still hope! This is forever…God bless!


    We all know God exists. Why? Because without Him, we couldn’t prove anything at all. Do we live our lives as if we cannot know anything? No. So why is God necessary? In order to know anything for certain, you would have to know everything, or have revelation from somebody who does. Who is capable of knowing everything? God. So to know anything, you would have to be God, or know God.

    A worldview without God cannot account for the uniformity and intelligibility of nature. And why is it that we can even reason that God is the best explanation for this if there is no God? We are given reason to know or reject God, but never to know that He does not exist.

    It has been calculated by Roger Penrose that the odds of the initial conditions for the big bang to produce the universe that we see to be a number so big, that we could put a zero on every particle in the universe, and even that would not be enough to use every zero. What are the odds that God created the universe? Odds are no such thing. Who of you would gamble your life on one coin flip?

    Is there evidence that the Bible is the truth? Yes. Did you know that the creation accounts listed in the book of Genesis are not only all correct, but are also in the correct chronological order? That the Bible doesn’t say the Earth was formed in six 24-hour days but rather six long but finite periods of time? That the Bible makes 10 times more creation claims than all major “holy” books combined with no contradictions, while these other books have errors in them? The Bible stood alone by concurring with the big bang saying, “In the beginning God created the heaven and the earth” (Genesis 1:1); and says our universe is expanding, thousands of years before scientists discovered these things. Watch a potential life-changing video on the website listed below with Astronomer(PhD) Hugh Ross explaining all these facts based on published scientific data. He has authored many books, backed even by atheist scientists.

    Jesus came to pay a debt that we could not; to be our legal justifier to reconcile us back to a Holy God; only if we are willing to receive Him: “For the wages of sin is death…” (Romans 6:23).

    God so loved the world that He gave us His only begotten son, so that whoever believes in Him, through faith, shall not perish, but have everlasting life. Jesus says if we wish to enter into life to keep the commands! The two greatest commands are to love God with all your heart, soul, strength, and mind; and your neighbor as yourself. All the law hang on these commands. We must be born of and lead by the Holy Spirit, to be called children of God, to inherit the kingdom. If we are willing to humble ourselves in prayer to Jesus, to confess and forsake our sins, He is willing to give the Holy Spirit to those who keep asking of Him; giving us a new heart, leading us into all truth!

    Jesus came to free us from the bondage of sin. The everlasting fire was prepared for the devil and his angels due to disobedience to God’s law. If we do the same, what makes us any different than the devil? Jesus says unless we repent, we shall perish. For sin is the transgression of the law. We must walk in the Spirit so we may not fulfill the lusts of the flesh, being hatred, fornication, drunkenness and the like. Whoever practices such things will not inherit the kingdom (Galatians 5:16-26). If we sin, we may come before Jesus to ask for forgiveness (1 John 2:1-2). Evil thoughts are not sins, but rather temptations. It is not until these thoughts conceive and give birth by our own desires that they become sin (James 1:12-15). When we sin, we become in the likeness of the devil’s image, for he who sins is of the devil (1 John 3:8); but if we obey Jesus, in the image of God. For without holiness, we shall not see the Lord (Hebrews 12:14).

    The oldest religion in the world is holiness through faith (James 1:27). What religion did Adam and Eve follow before the fall? Jesus, Who became the last Adam, what religion does He follow? Is He not holy? He never told us to follow the rituals and traditions of man but to take up our cross and follow Him (Luke 9:23). There are many false doctrines being taught leading people astray. This is why we need the Holy Spirit for discernment. Unlike religion, holiness cannot be created. It is given to us from above by the baptism of the Spirit. Jesus is more than a religion; He is about having a personal relationship with the Father. Start by reading the Gospel of Matthew, to hear the words of God, to know His character and commandments. Follow and obey Jesus, for He is the way, the truth, and the life!

  6. Hi! I could have sworn I’ve been to this website before but after
    browsing through some of the post I realized it’s new to
    me. Anyhow, I’m definitely glad I found it and I’ll be bookmarking and
    checking back frequently!

  7. I simply had to thank you very much once again. I’m not certain what I would’ve made to happen without the entire secrets shared by you over that field. Completely was an absolute difficult case in my view, nevertheless discovering the very professional avenue you treated it took me to weep over fulfillment. Now i’m thankful for your assistance as well as wish you realize what a great job you are undertaking educating some other people using your site. More than likely you’ve never encountered all of us.

Leave a Reply