Thumb & Wrist Pain: Understanding De Quervain's Tenosynovitis

Pain around the thumb side of the wrist can make everyday tasks like lifting, typing, gripping, or even holding a baby uncomfortable. One common cause of this type of pain is a condition called De Quervain's Tenosynovitis (DQT).

DQT is an overuse injury that affects the tendons near the base of the thumb, in an area sometimes referred to as the “snuff box” of the wrist. These tendons help move and stabilise the thumb, and when they become irritated, swollen, or overloaded, simple movements can become painful.

What causes it?

The exact cause is not always clear, but DQT is commonly linked to repetitive hand and thumb movements. Over time, the tendon covering can become thickened and irritated, making movement more difficult and painful.

People more commonly affected include:

  • Parents caring for young babies

  • Chefs and hospitality workers

  • Gardeners

  • Tennis players

  • People who spend long periods typing or using their hands repetitively

Common symptoms

You may notice:

  • Pain near the base of the thumb

  • Wrist pain when gripping or lifting

  • Swelling around the thumb side of the wrist

  • Pain when twisting jars, lifting children, or texting

  • Reduced grip strength

Treatment options

Treatment often focuses on reducing irritation and allowing the tendons to settle. This may include:

  • Wearing a thumb splint (thumb spica splint)

  • Activity modification

  • Corticosteroid injections

  • Physiotherapy rehabilitation

While injections and splints can help reduce pain, rehabilitation exercises are an important part of long-term recovery.

Helpful rehabilitation exercises

A physiotherapy program may include:

  1. Gentle thumb strengthening exercises

  2. Tendon gliding exercises

  3. Nerve gliding exercises

  4. Postural correction and upper body strengthening

These exercises aim to improve movement, reduce strain on the wrist and thumb, and help prevent symptoms from returning.

Why rehab is important

Research suggests that symptoms can return in many people if treatment only focuses on injections or immobilisation without proper rehabilitation.

Starting guided rehab exercises soon after treatment can help improve long-term outcomes and reduce the chance of the pain coming back.

When to seek help

If thumb or wrist pain is affecting your daily activities, it’s important to get an accurate diagnosis and treatment plan. A physiotherapist can help identify the cause of your pain and guide you through a structured rehabilitation program tailored to your needs.

If you are experiencing ongoing thumb or wrist pain, feel free to book an appointment with our friendly team of physio’s today to discuss the best management approach for you.

This information reflects current evidence and clinical experience in physiotherapy.

Author: Jack Qin, Balance North Preston Physiotherapist

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