Hand physiotherapy
Wrist and Thumb Pain: could it be De Quervain's disease?
Introduction
Pain on the outer side of the wrist, especially near the thumb, can be caused by irritation of the tendons responsible for thumb movement:
- abductor pollicis longus (APL)
- extensor pollicis brevis (EPB)
These tendons run inside a small tunnel. When the sheath surrounding them becomes inflamed or thickened, their gliding becomes difficult and painful.
Why does De Quervain's disease occur?
There is no single cause. This disorder often appears due to:
- repetitive thumb or wrist movements (texting, lifting objects, manual work)
- functional overload from daily or work activities
- hormonal changes, particularly during pregnancy or after childbirth
- inflammation of the tissues surrounding the tendons
Who can develop it?
De Quervain's disease is more common:
- in women between 30 and 50 years old
- in those who use the thumb and wrist intensively
- in teenagers and adults who use smartphones a lot
- in people who perform strong grips or repetitive movements
How are the symptoms recognised?
Common signs:
- pain on the outer side of the wrist
- difficulty gripping
- swelling or stiffness
- pain when bending the thumb or tilting the wrist toward the little finger
Tests used:
- Finkelstein
- WHAT test
Can it heal on its own?
Sometimes yes, but early assessment reduces recovery time and the risk of becoming chronic.
What can physiotherapy do?
- education on correct movements
- specific exercises for mobility and strength
- manual therapy
- use of splints
If physiotherapy is not enough
- corticosteroid injections
- surgery
How does surgery work?
A 2–3 cm incision on the wrist, opening of the tendon tunnel, under local anaesthesia. A short post-operative immobilisation is possible. Rehabilitation helps recover mobility and strength.
Healing times
- mild forms: a few weeks
- chronic forms: longer
💡 Timely intervention by the physiotherapist can reduce pain and prevent the disorder from becoming chronic.
References
- Abi-Rafeh R., Kazan R. Conservative Management of de Quervain Stenosing Tenosynovitis. Plast Reconstr Surg. 2020.
- Goel R., Abzug J.M. De Quervain's tenosynovitis. HAND. 2015.
- Young S.W., et al. Conservative management of De Quervain's. Physiother Theory Pract. 2020.
