De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a condition that causes pain and inflammation in the tendons on the thumb side of the wrist. It often develops from repetitive hand or wrist movements and can make gripping, lifting, or texting painful. Physical therapy helps reduce inflammation, restore movement, and prevent the condition from returning.

Do you feel pain along the thumb side of your wrist when gripping, texting, lifting a baby, or wringing out a towel? You may be experiencing De Quervain’s tenosynovitis, a condition caused by irritation of the tendons that move your thumb.

At Rose Physical Therapy, with clinics in Navy Yard, Friendship Heights, and Farragut North in Washington, DC, our experienced physical therapists provide personalized treatment to relieve wrist pain, restore thumb function, and help prevent future flare-ups.

What Is De Quervain’s Tenosynovitis?

De Quervain’s tenosynovitis affects two important thumb tendons in the wrist:

• Abductor pollicis longus (APL)
• Extensor pollicis brevis (EPB)

These tendons help move the thumb away from the hand and assist with gripping and lifting.

Both tendons pass through a narrow tunnel on the thumb side of the wrist. When these tendons become irritated or overused, the surrounding tissue can become inflamed, making thumb and wrist movements painful.

Common Causes of De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis often develops from repetitive strain or overuse of the thumb and wrist.

Common contributing factors include:

• Repetitive thumb or wrist movements such as texting, typing, knitting, or gaming
• Lifting infants or heavy objects with the wrist bent forward
• Poor wrist mechanics during exercise or daily activities
• Sudden increases in hand or arm activity
• Inflammatory conditions such as rheumatoid arthritis
• Hormonal changes during pregnancy or the postpartum period

Because of these factors, the condition is sometimes referred to as “mother’s wrist” or “gamer’s thumb.”

Symptoms of De Quervain’s Tenosynovitis

This condition often causes pain and limitations during everyday hand use.

Common symptoms include:

• Pain along the thumb side of the wrist
• Swelling near the base of the thumb
• Tenderness when pressing on the affected area
• Difficulty gripping or holding objects
• Pain when turning doorknobs, opening jars, or texting
• A catching or snapping sensation when moving the thumb

A common clinical test for this condition is the Finkelstein test, which may cause pain when the thumb is bent into the palm and the wrist is tilted toward the pinky side.

How De Quervain’s Tenosynovitis Is Diagnosed

At Rose Physical Therapy, diagnosis begins with a detailed physical therapy evaluation.

Your physical therapist may assess:

Thumb and wrist movement
Evaluating range of motion and strength.

Tendon tenderness
Checking for irritation along the thumb-side wrist.

Grip mechanics
Observing how the hand and wrist move during daily tasks.

Functional activities
Identifying movements that trigger symptoms.

Imaging such as X-rays or MRI is rarely needed unless another condition, such as arthritis or fracture, is suspected.

Physical Therapy Treatment for De Quervain’s Tenosynovitis

Treatment focuses on reducing tendon irritation while restoring strength and movement in the hand and wrist.

Your care plan at Rose Physical Therapy may include:

Manual Therapy

Hands-on techniques such as soft tissue mobilization and tendon gliding to reduce tension around the affected tendons.

Activity Modification

Guidance on adjusting daily movements to reduce stress on the thumb and wrist.

Splinting or Taping

Supportive taping or splints may be recommended to protect the tendons during healing.

Stretching and Mobility Exercises

Exercises designed to improve flexibility in the thumb, wrist, and forearm.

Strengthening Exercises

Progressive strengthening for the thumb, wrist, and forearm muscles to improve resilience and reduce future injury risk.

Ergonomic Guidance

Advice on proper hand positioning during work, childcare, exercise, and daily tasks.

Home Exercise Program

A customized exercise routine designed to support recovery between therapy sessions.