To diagnose de Quervain tenosynovitis, your health care provider will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist.
You may be asked to perform a Finkelstein test, in which you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain tenosynovitis.
Imaging tests, such as X-rays, generally aren’t needed to diagnose de Quervain tenosynovitis.
Treatment for de Quervain tenosynovitis is aimed at reducing inflammation, preserving movement in the thumb and preventing recurrence.
If you start treatment early, your symptoms should improve within 4 to 6 weeks. If de Quervain tenosynovitis starts during pregnancy, symptoms are likely to end around the end of either pregnancy or breastfeeding.
To reduce pain and swelling, your doctor may recommend using pain relievers that you can buy without a prescription. These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
Your doctor may also recommend injections of corticosteroid medications into the tendon covering to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.
Initial treatment of de Quervain tenosynovitis may include:
You may also see a physical therapist or an occupational therapist. The therapist may review how you use your wrist and give suggestions on how to relieve stress on your wrists. Your therapist can also teach you exercises for your wrist, hand and arm. These exercises can strengthen your muscles, reduce pain and limit tendon irritation.
Surgery may be recommended for more-serious cases. The surgery is outpatient. In the procedure, the surgeon inspects the sheath surrounding the involved tendon or tendons and then opens the sheath to release the pressure. This allows the tendons to glide freely.
Your health care provider will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical therapist or an occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.
If you don’t need surgery, caring for your condition is much the same as preventing it:
Make an appointment with your health care provider if you have hand or wrist pain and if avoiding the activities that trigger the pain aren’t helping. After an initial exam, you may be referred to an orthopedist, a rheumatologist, a hand therapist or an occupational therapist.
Here’s some information to help you get ready for your appointment.
Below are some basic questions to ask the health care provider who evaluates you for wrist- or hand-related symptoms.
Don’t hesitate to ask other questions as well.
A health care provider who sees you for symptoms common to de Quervain tenosynovitis may ask a number of questions. You might be asked:
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