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What is De Quervain’s tenosynovitis?
On the thumb side of the wrist, two tendons run side by side through a narrow tunnel (a sheath); they move the thumb away from the hand and straighten it. When the tendons and the sheath around them become irritated and thickened, gliding through the tunnel becomes painful, especially when you grip with the thumb while moving the wrist. The exact cause is often unclear, but it is linked with repeated thumb and wrist movements, and the pain is commonly brought on by tasks such as lifting and holding a baby, wringing out clothes, gardening or gripping tools. It is more common in women, especially those caring for a young baby.
Common signs
- Pain and tenderness on the thumb side of the wrist, which may spread into the thumb or up the forearm
- Pain that is worse with gripping, pinching, twisting or lifting, such as picking up a baby, wringing a cloth or opening a jar
- Mild swelling over the thumb side of the wrist
- A clicking, creaking or catching feeling when the thumb moves
Common misunderstandings
- "I have to stop using my hand completely": it is usually enough to reduce or change the movements that bring on the pain for a while, and then build up use gradually
- "An injection is the only real solution": many people improve with advice, changes to aggravating movements and a splint; an injection may help some people, sometimes only for a while, and the decision is the doctor’s
- "Any pain at the base of the thumb is De Quervain’s": pain after a fall on the hand may come from a broken bone, and pain at the base of the thumb can also come from arthritis of the thumb joint, so a careful examination matters
What usually helps?
A European expert-consensus guideline advises that clear explanation and advice should always be part of care, combined with other measures chosen according to how severe the condition is and how long it has lasted. In practice this usually means reducing or changing the movements that provoke the pain for a while, such as how you lift and hold your baby or how you grip and wring things, and taking short breaks. A splint that supports the thumb and wrist may help rest the tendons for a period when advised. As the pain settles, we build up gentle thumb and wrist exercises gradually, followed by strengthening of the forearm and hand, although research on exercise for this condition is still limited. Manual therapy, soft-tissue techniques and release of muscle knots around the forearm may be used as part of the plan to ease pain, not on their own, although the evidence for them in this condition is also limited. A steroid injection may ease pain for some people, sometimes only for a while, and surgery is considered for some cases that do not settle; both are the doctor’s decision.
How we treat it at Revibe
- We listen: when the pain started, which movements bring it on, and your daily tasks, such as caring for a baby, phone use or work with your hands
- We examine the wrist, thumb, forearm, elbow and neck, sensation and grip strength, and look for signs that need a doctor or an X-ray
- We identify what keeps the pain going, such as repeated gripping and lifting or the way you use your hand
- We treat: manual therapy, release of muscle knots in the forearm and soft-tissue techniques around the wrist, with advice on a suitable splint when needed
- We progress with a graded home exercise programme and advice on daily movements until you are back to your usual activities
When do you need urgent medical care?
- A visible deformity of the wrist or thumb after a fall or injury, or being unable to move them — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
- Pain in the hollow at the base of the thumb after a fall on the hand, which may be a fracture of a small wrist bone (the scaphoid) — see a doctor the same day
- A hot, red, swollen wrist or thumb with fever — see a doctor the same day
- New numbness, tingling or weakness in the hand or fingers
- Severe constant pain that does not ease with rest, night pain with unexplained weight loss, or swelling and stiffness in several joints
In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.
FAQ
Do I need an X-ray or a scan?
Usually not to start treatment, because the diagnosis is mainly made by examination. We refer you for imaging or to a doctor after a fall on the hand, when another cause is suspected, or if things do not improve as expected.
Do I need an injection or surgery?
Not in most cases at the start. Many people improve with advice, changes to daily movements, a splint when advised and exercise. An injection may help some people, and surgery is considered for some cases that do not settle; both decisions belong to the doctor.
I have a young baby. What can I do?
There is no need to stop caring for your baby. Small changes help, such as sharing the lifting with others, changing how you lift and hold the baby, taking short breaks and using a splint when advised. We show you practical ways that suit you.
How many sessions will I need?
It depends on your condition and how long you have had it; after the first assessment we explain the plan and the expected number of sessions.
More common questions: Elbow, wrist and hand questions — 15 questions
Ready to start?
Book your first session at Revibe Clinic in Amman (it starts with an assessment), or message us on WhatsApp.
Related pages
Source: Huisstede BM et al. (2014). Consensus on a Multidisciplinary Treatment Guideline for de Quervain Disease: Results From the European HANDGUIDE Study. Phys Ther 94(8):1095–1110 · British Society for Surgery of the Hand — De Quervain’s syndrome · Berkshire Healthcare NHS Foundation Trust — Physiotherapy advice for De Quervain’s tendinopathy
Reviewed by Ahmed AlKhatib, licensed physiotherapist — 31 October 2026
This information is general education and does not replace a clinical assessment.