About de Quervain's tenosynovitis
Two tendons that move the thumb outward run together through a tunnel on the thumb side of the wrist. In De Quervain's tenosynovitis, the tunnel and its lining thicken, so the tendons rub and become painful. Some people also have an extra wall inside the tunnel that crowds the tendons further.
It is common in new parents, who lift a baby with the thumb spread wide, and in people who do repeated wrist and thumb motions at work or in sports. Pain can be sharp enough to make simple tasks, like pouring from a pitcher, hard to do.
Common symptoms
- Pain and tenderness on the thumb side of the wrist
- Pain that worsens with gripping, lifting, or twisting
- Swelling over the base of the thumb
- A catching or squeaking feeling when the thumb moves
Common causes and risk factors
- Lifting a baby or toddler with the thumb spread wide
- Repetitive wrist and thumb motions at work or in racquet and paddle sports
- Hormonal changes during pregnancy and after childbirth
- A direct blow to the wrist
How we diagnose it
Dr. Gruner examines the wrist and uses simple stretch tests that reproduce the pain. Ultrasound at the exam table shows thickening of the tendon sheath and whether there is an extra compartment inside it, which affects where an injection should go. It also helps rule out nearby problems such as thumb arthritis or a nerve irritation.
How Propel treats de Quervain's tenosynovitis
Most people improve with a thumb spica splint for a few weeks, changes to how they lift and grip, and a gradual strengthening program once pain calms down. For new parents, small changes in lifting technique often make a real difference. We aim to keep you using your hand, not to stop you from using it.
When pain lingers, an ultrasound-guided injection places medicine directly into the tendon sheath, including any separate compartment that could otherwise be missed. For symptoms that keep returning, PRP may be an option to support tendon healing. Rarely, persistent cases are referred for a surgical release.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about de Quervain's tenosynovitis
- Why does it matter where the injection goes for De Quervain's?
- Some people have a thin wall dividing the tendon tunnel into two sections. An injection placed without imaging can reach only one of them. Ultrasound lets us see that anatomy and place the medicine where it is needed.
- Is De Quervain's common after having a baby?
- Yes. Hormonal changes and the repeated motion of lifting a baby make new parents especially prone to it. Splinting, lifting changes, and a well-placed injection usually help, and we can talk through options if you are breastfeeding.
- How long does De Quervain's take to get better?
- Mild cases often improve over several weeks with splinting and activity changes. Longer-standing cases can take more time and may need an injection. We track your progress and adjust the plan as you go.