De Quervain’s Syndrome (Tendonitis)

De Quervain’s syndrome is a common condition that affects the thumb side of the wrist. The tendon inflammation (termed tendonitis or tenosynovitis) can occur in any person but is especially common in new parents (or grandparents) with a newborn child (perhaps due to the repetition of lifting). Pain is often aggravated by moving the thumb and when using scissors. Wrist swelling or a clicking or scratching of the tendons is sometimes present.

There are other causes of pain in the region of the thumb base, wrist and forearm and a thorough assessment will help to identify the cause.

Do you experience pain around the thumb base or wrist? Do you care for a newborn child?

  • De Quervain’s syndrome is due to inflammation (and thickening) of a group of tendons at the thumb side of your wrist (the tendons help to move your thumb and wrist and are called extensor tendons). The tendons enter a tunnel (called the first extensor compartment) as they approach the wrist and a size mismatch causes pain and mobility issues (the tendons become too swollen for the tunnel).

  • The cause of De Quervain’s syndrome remains unknown for many people, but is especially common in new parents (or grandparents) with a newborn child (perhaps due to the repetition of lifting and the sustained position of the hand and wrist when supporting the child). Overuse or repetitive movements can also predispose to this condition.

  • Some of the potential symptoms of De Quervain’s syndrome are listed below.

    Typically present:

    • Pain along the thumb side of your wrist and neighbouring forearm. 

    • Pain made worse with thumb and wrist movements.

    • Tenderness when pressing along the site of pain.

    Sometimes present:

    • Swelling at the site of pain.

    • Clicking, snapping or a scratching feeling at the site of pain.

    • Stiffness of the thumb.

  • It is important to correctly diagnose De Quervain’s syndrome and exclude other causes of pain in this area, such as thumb base arthritis, wrist arthritis and other tendon disorders.

    The diagnosis is usually made on the history (your symptoms) and clinical examination. Assessment with an ultrasound scan is sometimes required if the diagnosis is unclear.

    • Non-surgical treatment options include simple painkillers, massage with topical anti-inflammatory gel and hand therapy for exercises and splintage. An injection of steroid (e.g. cortisone) at the site of the tunnel (first extensor compartment) in your wrist is sometimes used for intrusive symptoms that are not settling.

    • Surgical treatment is De Quervain’s decompression (also termed release), whereby the tunnel (first extensor compartment) overlying the tendons at the wrist is opened up to provide more space for the tendons to glide. 

    Matthew offers all the above treatments. He can refer you for hand therapy if required.

    De Quervain’s surgery is often performed under local anaesthesia. Matthew typically uses the WALANT anaesthetic technique which avoids the use of an arm tourniquet (therefore avoiding tourniquet pain). Click here for an overview of the different types of anaesthesia and the general risks of hand surgery.

    The specific risks associated with De Quervain’s surgery will be discussed if surgery is an option, but includes continuing or new pain, scar issues and numbness.

  • You can read more detailed information about De Quervain’s syndrome on the Lothian Hand Unit website.

    The British Society for Surgery of the Hand (BSSH) has an informative webpage on De Quervain’s syndrome, which can be downloaded as a patient information leaflet PDF.

The information contained on this page is for guidance only and should not be considered a substitute for medical assessment and advice by a suitably trained doctor or clinician. External links have been provided for your information and convenience and we are not responsible for their content or accuracy.