De Quervains tenosynovitis
Guided Injections.
What is De Quervain’s tenosynovitis?
De Quervain’s is a painful condition involving the abductor pollicus longus (APL) and extensor pollicus brevis (EPB) tendons on the thumb side of the wrist. These tendons mostly become irritated near the thumb’s base, passing through a narrow sheath known as the first extensor compartment. With injury, these tendons become thickened, resulting in painful friction between the tendons and the sheath (Challoumas et al., 2023).
What are the common symptoms of this?
Movements of the thumb and wrist aggravate pain and swelling on the thumb side of the wrist. You may experience discomfort with gripping, pinching, lifting a baby, typing, and texting. Weakness of the hand and wrist is also commonly associated with this condition (Bosman et al., 2022)
How is this diagnosed?
To assess your condition, your physiotherapist will ask about your symptoms and conduct a physical examination, looking for the following:
- Range of movement quality and strength of the thumb and wrist
- Any signs of injury or inflammation
- Pain with movements such as thumb extension, thumb abduction and gripping
- Pain with palpation, stretch, and resistance of APL and EPB
Your physiotherapist may also recommend further investigation, such as ultrasound or MRI, to assess changes in the tendons, including thickening, disorganisation of collagen fibres, and increased vascularity.
Treatment options
Guided Corticosteroid Injections
For persistent pain, corticosteroid injections may be recommended to reduce inflammation and provide short-term relief.
Your Clinician
BSc Physiotherapy MSCP (Hons)
PGCert Independent Medical Prescriber
PGCert Soft Tissue and Joint Injection Therapist
PGCert Diagnostic Ultrasound
Challoumas, D., Ramasubbu, R., Rooney, E., Seymour-Jackson, E., Putti, A., & Millar, N. L. (2023). Management of de Quervain tenosynovitis: a systematic review and network meta-analysis. JAMA Network Open, 6(10), e2337001-e2337001.
Bosman, R., Duraku, L. S., van der Oest, M. J., Hundepool, C. A., Rajaratnam, V., Power, D. M., … & Zuidam, J. M. (2022). Surgical treatment outcome of de Quervain’s disease: a systematic review and meta-analysis. Plastic and Reconstructive Surgery–Global Open, 10(5), e4305.