Pain along the thumb side of your wrist can make even simple activities—lifting a cup, texting, or gripping a steering wheel—feel difficult. One of the most common causes of this pain is De Quervain’s Tenosynovitis, a condition involving inflammation of the tendons that control thumb movement.
This inflammation causes the tendons to swell within their narrow sheath, resulting in pain and tenderness, especially when forming a fist, grasping, or rotating the wrist.
At Dr. Burke Orthopedics, we provide comprehensive evaluation and personalized treatment for De Quervain’s Tenosynovitis to help patients across Pearland, Houston, Friendswood, and Southeast Texas regain comfort and mobility.
Two tendons—the abductor pollicis longus and the extensor pollicis brevis—run side by side along the thumb and pass through a fibrous tunnel on the wrist’s radial (thumb) side. These tendons allow the thumb to move away from the hand and straighten.
When repetitive movement or irritation causes the sheath surrounding these tendons to thicken or become inflamed, the tendons cannot glide smoothly. The resulting friction creates pain, swelling, and sometimes a catching or “snapping” sensation during motion.
De Quervain’s Tenosynovitis typically develops from repetitive wrist or thumb movement, but several factors can increase risk.
Common causes include:
- Repetitive grasping or twisting: Frequent lifting of infants (“mommy thumb”), gardening, or texting.
- Occupational strain: Hairdressers, office professionals, and assembly workers often experience overuse.
- Sports or hobbies: Activities requiring strong grip—tennis, golf, knitting, or playing instruments.
- Direct injury: A fall or blow to the wrist can inflame the tendon sheath.
- Arthritis: Rheumatoid arthritis or degenerative joint changes may extend inflammation to surrounding tendons.
- Pregnancy and postpartum changes: Hormonal shifts and repetitive lifting motions increase tendon swelling.
Though the condition can affect anyone, it is most common in women between ages 30 and 50.
De Quervain’s Tenosynovitis often begins gradually and worsens over time.
Typical symptoms include:
- Pain or tenderness on the thumb side of the wrist, especially during motion
- Swelling near the base of the thumb
- A catching or snapping feeling when moving the thumb
- Difficulty gripping or pinching objects
- Pain that radiates up the forearm
- Increased discomfort when twisting the wrist, such as opening jars or turning keys
Many patients describe sharp pain when forming a fist or bending the thumb toward the palm. If untreated, the inflammation can limit wrist function and cause chronic discomfort.
At Dr. Burke Orthopedics, diagnosis begins with a detailed discussion of symptoms and physical activities, followed by a thorough examination.
Diagnostic steps include:
- Palpation: Dr. Robert L. Burke gently presses the wrist and thumb area to locate tenderness and swelling.
- Finkelstein test: The patient places their thumb inside a closed fist and bends the wrist toward the little finger. Sharp pain along the wrist’s thumb side indicates De Quervain’s Tenosynovitis.
- Range-of-motion assessment: Evaluates how pain affects wrist and thumb mobility.
- Imaging tests: X-rays usually appear normal but may rule out arthritis or bone injury; ultrasound can confirm tendon sheath inflammation if needed.
This thorough evaluation ensures the diagnosis is accurate and that similar conditions—like arthritis or nerve entrapment—are ruled out.
The primary goal of treatment is to reduce inflammation, relieve pain, and restore smooth tendon motion. Most patients improve with non-surgical care, though persistent or severe cases may require a simple surgical procedure.
Non-Surgical Treatments
- Activity modification: Avoiding repetitive thumb or wrist motion that triggers pain.
- Thumb spica splint: Immobilizes the thumb and wrist to allow rest and healing.
- Cold therapy and anti-inflammatory medication: Reduce pain and swelling.
- Gentle stretching and strengthening exercises restore range of motion and prevent stiffness.
- Corticosteroid or PRP injections: Targeted injections relieve inflammation and promote healing.
Surgical Treatments
When non-surgical methods fail, De Quervain’s Release Surgery may be recommended.
This outpatient procedure releases the tight sheath surrounding the affected tendons, allowing them to glide freely again. Dr. Burke performs this using precise, minimally invasive techniques designed to reduce recovery time and scarring.
Recovery depends on the severity of inflammation and the chosen treatment.
- Non-surgical recovery: Most patients experience relief within 4–6 weeks after rest, splinting, and therapy.
- Surgical recovery: Light movement begins almost immediately; most patients resume normal activity within 6–8 weeks.
Rehabilitation tips:
- Perform prescribed stretches daily to maintain flexibility.
- Avoid lifting heavy objects or repetitive twisting during recovery.
- Use ergonomic tools to reduce wrist strain.
- Gradually strengthen wrist and thumb muscles under therapist guidance.
Dr. Burke’s team provides customized rehabilitation programs to ensure long-term tendon health and prevent recurrence.
With timely treatment, the outlook for De Quervain’s Tenosynovitis is excellent. Most patients regain full function without lasting symptoms.
Preventive measures include:
- Taking frequent breaks from repetitive tasks
- Maintaining proper wrist posture and ergonomics
- Warming up before physical activity
- Using supportive splints or braces during repetitive work
Proper early care minimizes the risk of chronic inflammation and tendon thickening.
Seek orthopedic evaluation if you experience:
- Persistent pain along the thumb side of the wrist
- Swelling that worsens with activity
- Clicking, snapping, or locking when moving the thumb
- Pain that interferes with daily tasks or sleep
- Lack of improvement with rest or over-the-counter medication
Early treatment prevents tendon scarring and permanent restriction of motion.
Take the First Step Toward Relief
If wrist or thumb pain is limiting your daily activities, you don’t have to live with discomfort. Early evaluation can restore mobility and prevent chronic tendon problems.
At Dr. Burke Orthopedics, we combine advanced orthopedic knowledge with compassionate care to help you return to a pain-free, active lifestyle.
We proudly serve patients throughout Pearland, Houston, Friendswood, and Southeast Texas.
Call (713) 436-3488 or Request an Appointment Online to schedule a consultation with Dr. Robert L. Burke, board-certified orthopedic surgeon specializing in hand and wrist conditions.
