De Quervain’s Tenosynovitis can sneak up on you, making even simple tasks like lifting a cup or typing feel painful. If you’re experiencing pain on the thumb side of your wrist, it could be due to this condition. 

As a seasoned physiotherapist, I’m here to shed light on the symptoms, causes, and effective physiotherapy treatments that can help you overcome De Quervain’s and regain effortless hand function.

Key Takeaways:

  • Symptoms: Pain, swelling at the base of the thumb, difficulty gripping, and increased pain with wrist movement.
  • Causes: Repetitive thumb and wrist motions, such as typing, playing instruments, or gardening.
  • Physiotherapy: Strengthening exercises, ice therapy, and splints to help reduce pain and support healing.

What is De Quervain’s Tenosynovitis?

De Quervain’s Tenosynovitis occurs when the tendons that move your thumb become inflamed. 

This inflammation affects the sheath surrounding these tendons, leading to pain, swelling, and difficulty in moving your thumb or wrist. 

It often hits people who perform repetitive wrist and thumb motions, whether it’s from typing all day, gaming, or even lifting a baby frequently.

Anatomy of the Wrist

Your wrist is a complex structure made up of small bones, ligaments, and tendons, all working together for smooth movement. 

In De Quervain’s, the tendons on the thumb side of your wrist, specifically the abductor pollicis longus and extensor pollicis brevis, become irritated as they pass through a tunnel of bones and ligaments. 

Inflammation here can make even the slightest movement painful.

Symptoms of De Quervain’s Tenosynovitis

This condition tends to build slowly. You might notice a slight ache that worsens over time, especially during thumb movements.

Common signs include:

  • Pain near the base of the thumb, which may extend up the forearm.
  • Swelling at the wrist.
  • Difficulty gripping or pinching.
  • A catching or snapping feeling when moving your thumb.

These symptoms become particularly noticeable when performing tasks like opening jars, lifting objects, or even typing.

Causes of De Quervain’s Tenosynovitis

This condition usually results from repetitive motions that strain the wrist and thumb. Activities like knitting, gardening, playing racquet sports, or lifting infants repeatedly can trigger it.

Risk factors include:

  • Overuse: Repetitive wrist and thumb motions are the main cause.
  • Pregnancy: Hormonal changes during pregnancy can cause swelling and inflammation, increasing susceptibility.
  • Age: Typically affects those between 30 and 50 years old.
  • Prior Injuries: If you’ve had wrist injuries before, you’re at higher risk.

Diagnosis of De Quervain’s Tenosynovitis

Diagnosis involves a physical exam where a healthcare provider checks for tenderness, swelling, and limited movement in the thumb. The Finkelstein test—where you bend your thumb across your palm and then move your wrist toward your little finger—is commonly used to diagnose De Quervain’s. If this causes sharp pain, it’s a strong indicator.

Sometimes, imaging tests like ultrasound or X-rays are used to rule out fractures or arthritis, giving a clearer view of what’s happening with the tendons.

Physiotherapy Treatments for De Quervain’s Tenosynovitis

Physiotherapy is often a go-to treatment for De Quervain’s, and it’s highly effective in reducing pain, improving mobility, and preventing the issue from returning. A qualified physiotherapist will design a personalized program for you.

Rest and Activity Modification

The first step is usually rest. Avoid activities that aggravate your wrist and thumb. You might need to take a break from sports, typing, or other repetitive tasks that worsen the condition. Modifying how you hold objects or using voice-to-text software can help reduce strain on your wrist.

Splinting

Splinting your wrist and thumb can provide much-needed rest by immobilizing the area. Wearing a splint for a few weeks helps reduce inflammation by keeping the tendons in a neutral position.

Ice Therapy

Applying ice to the affected area for 15-20 minutes a few times a day can help decrease swelling and numb the pain. It’s a simple but effective home treatment.

Physiotherapy Exercises

A major part of your recovery will involve exercises to stretch and strengthen the muscles around your wrist and thumb. Here are a couple of examples:

  • Wrist Extensor Stretches 

Gently stretch your wrist by extending it with your other hand, holding the stretch for 15-20 seconds.

  • Thumb Strengthening

Use a stress ball or soft putty to strengthen your grip, focusing on controlled, pain-free movements.

These exercises help regain strength, flexibility, and range of motion without causing further damage. A physiotherapist will guide you through these exercises to ensure proper technique and gradual progression.

Manual Therapy and Ultrasound

Your physiotherapist may also use manual therapy, such as massage or mobilization techniques, to relieve tightness in your wrist and forearm. Ultrasound therapy can also be used to promote healing by increasing blood flow and reducing inflammation in the tendons.

Preventing De Quervain’s Tenosynovitis

Once you’ve recovered, preventing the condition from returning is crucial. Here’s how:

  • Take breaks

If your job involves repetitive wrist movements, take frequent breaks to rest your hands.

  • Modify your techniques

Adjust how you grip or hold objects to avoid unnecessary strain.

  • Stay consistent with exercises

Keep up with your physiotherapy exercises to maintain wrist strength and flexibility.

Conclusion

De Quervain’s Tenosynovitis may seem minor at first, but without proper treatment, it can disrupt your daily life. Physiotherapy offers a comprehensive and effective solution to reduce your pain, restore function, and prevent recurrence.

Don’t let wrist pain hold you back – seek professional help at Surf & Sports Myotherapy and get back to enjoying your everyday activities with confidence and comfort!