Treating De Quervain’s Syndrome
Discover the causes behind De Quervain’s syndrome, plus effective treatment and prevention strategies.
by Brad Walker | Updated July 13, 2025
De Quervain’s syndrome is a chronic injury of the thumb and wrist that can be very painful, and in extreme cases, debilitating.
The thumb and wrist are used in many actions during the course of a day. Gripping, holding, lifting, turning handles, driving a car and many other daily maneuvers require the thumb and the wrist.
The joints are held together by strong ligaments and tendons, which can be injured by acute forces, or become inflamed from overuse.
What is De Quervain’s Syndrome?
De Quervain’s syndrome (also referred to as de Quervain’s tenosynovitis, Radial styloid tenosynovitis, washerwoman’s sprain, or mother’s wrist) is a condition named for the Swiss surgeon Fritz de Quervain, who identified the condition in 1895. It is an inflammation of the sheath or covering, of two tendons of the thumb. This inflammation causes compression of the tendons, reducing their ability to slide through as needed for movement.
This condition is not commonly associated with any disease process or dangerous condition. It does, however, often require medical intervention to improve. This syndrome is more common in women than in men. De Quervain’s syndrome is like tennis elbow and carpal tunnel syndrome, in that it is a condition brought on by overuse.
Anatomy Involved
This condition involves two of the tendons that control movement in the thumb; abductor pollicus longus and extensor pollicus brevis, which are attached to muscles on the back of the forearm. These tendons travel side by side on the inside of the wrist and travel through an opening at the end of the radius bone. The lining of the opening, the tenosynovium, provides a slippery surface for the tendons to glide over as they move the thumb.
Inflammation of a tenosynovium is termed; tenosynovitis. In the case of De Quervain’s tenosynovitis, the inflammation causes an impingement of the tendons in the tunnel, causing friction on the tendons, further inflaming the tenosynovium and tendons.
What causes De Quervain’s Syndrome?
De Quervain’s syndrome is an overuse injury like many other chronic tendon injuries. Continuous gripping, pinching, squeezing or wringing motions can lead to this condition, hence the name washerwoman’s sprain. New mothers may also develop the condition from cradling their baby in the same arm for extended periods (thereby earning the name mother’s wrist.)
Injury to the wrist or thumb may lead to the development of scar tissue in this area, and as the scar tissue develops, the tendons become impinged. Arthritic conditions can also lead to tenosynovitis on the thumb. Arthritis is an inflammation, commonly found in joints, and so therefore this inflammation exacerbates the condition.
Signs and Symptoms
Pain in the thumb and lateral wrist, over the radius, especially during use, is common with this injury. Tenderness and swelling over the area may also be present. The pain may progress further up the forearm as the injury worsens. A progressive loss of function in the thumb may occur due to the increasing pain. Decreased range of motion of the thumb may also occur. Crepitus, or a creaking, may be experienced in the affected area.
De Quervain’s Treatment
De Quervain’s is a soft tissue injury of the muscles and tendons around the thumb and wrist joint, and therefore should be treated like any other soft tissue injury.
The initial treatment involves the application of R.I.C.E.R. (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment. It is critical that the R.I.C.E.R. regimen be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery. The following few points are of most importance.
- Rest and Immobilization: The first step in treating De Quervain’s is to stop any activity that makes the condition worse. Any further movement or stress will only aggravate the condition and prolong recovery. It is also important to keep the injured area as still as possible. Splinting with a thumb-spica splint may be necessary to reduce movement of the wrist and thumb joints.
- Ice: By far the most important part. The application of ice will have the greatest effect on reducing swelling and pain. Apply ice as soon as possible after the injury has occurred.
- Anti-inflammatory Medication: The use of NSAIDs (Non-steroidal anti-inflammatory drugs), and analgesic medication can also help to reduce pain and inflammation during the initial stages of treatment.
During the first 48 to 72 hours be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi’s and saunas. Avoid all movement and massage of the injured area. Also, avoid excessive alcohol. All these things will increase the swelling and pain of your injury.
- The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy techniques. The most common methods used to do this include ultrasound, heat and massage.
- Next, start to incorporate very gentle range of motion exercises for the muscle groups around the wrist and forearm.
- Once most of the pain has reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase is to regain the strength, power, endurance and flexibility of the muscles and tendons in the thumb, wrist and forearm.
If these interventions do not work, then a cortisone shot into the irritated area may be the next course of action. The last step, if all other interventions fail, is surgery to release the tendons and provide more space for them to move. Following the surgery physical therapy may still be required to retrain the movements that caused the injury.
De Quervain’s Prevention
Prevention of overuse injuries like De Quervain’s is much more important, and less costly, than treating them. Addressing the issues that can cause this type of injury helps lessen the chance of it occurring. Here are seven important things you can do to help prevent De Quervain’s syndrome.
- A proper warm-up before doing any lifting, grasping or holding for extended periods may prepare the muscles and tendons for the task, and prevent some of the strain placed on them.
- Avoiding activities that cause pain is a commonsense prevention method that is often ignored. If a movement causes pain, find another activity or action that accomplishes the same task without the pain.
- Avoid repetitive motions that cause this condition and retrain the body to reduce the strain on the wrist during daily activities will also help prevent De Quervain’s syndrome
- Rest is essential for healthy joints, tendons and ligaments. These structures cannot repair when they are under stress. They need rest to repair damage and rebuild. Consider breaking up sessions of work or practice into shorter periods with more frequent breaks to allow that area to rest and avoid overuse.
- Eating a sensible diet with essential fats and oils for lubrication, protein for repair and calcium for strong bones, along with other vitamins and minerals will reduce the risk of injury and provide the nutrients needed to stay healthy.
- Strengthening the wrist and forearm will provide the support needed in the wrist to prevent this condition. Muscles that are trained regularly are more supple and repair quicker. They are also much less prone to injuries that can lead to tendon issues. However, it is important not to contribute to the overuse syndrome through training, by choosing exercises that do not directly simulate the overused motion.
- Flexible muscles reduce overall tension on the tendons, which reduces the inflammation to the sheaths that cover them. Be sure to work on the flexibility of all the muscle groups in the arm, wrist and hand. See the photos below for two great wrist stretches for these muscle groups.
Research and References
- Allbrook, V. (2019). The side of my wrist hurts: De Quervain’s tenosynovitis. Australian Journal of General Practice, Volume 48, Issue 11, November 2019.
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Goel, R. Abzug, JM. (2015). de Quervain’s tenosynovitis: a review of the rehabilitative options. Hand (N Y), Mar;10(1):1-5.
- Mak, J. (2018). De Quervain’s Tenosynovitis: Effective Diagnosis and Evidence-Based Treatment. Work-related Musculoskeletal Disorders, Chapter 4.
- Martini, F. Tallitsch, R. Nath, J. (2009) Human Anatomy, 9th Edition (ISBN: 978-013432076X)
- Oh My Arthritis. (2022). de Quervain’s Tenosynovitis. Retrieved September 31, 2022, from https://www.ohmyarthritis.com/Learn/About-Health-Conditions/deQuervains-Tenosynovitis.html.
- Physiopedia contributors. (August 18, 2022). De Quervain’s Tenosynovitis. Retrieved September 29, 2022, from https://www.physio-pedia.com/index.php?title=De_Quervain%27s_Tenosynovitis&oldid=314647.
- Tortora, G. Derrickson, B. (2009) Principles of Anatomy and Physiology, 14th Edition (ISBN: 978-1118866096)
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Wikipedia contributors. (2022, September 29). De Quervain syndrome, In Wikipedia, The Free Encyclopedia.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
