Thumb tendinitis article image

Thumb tendinitis (de Quervain's syndrome)

De Quervain's thumb tendinitis is a painful inflammatory condition of the tendons on the side of the wrist. Treatment options for it include conservative management and surgical treatment for pain relief. 

What is thumb tendonitis? 

Tendons are bands of fibrous tissue that connect muscles to bones and help in everyday activities such as running and jumping

 These tendons are covered by a protective sheath that produces synovial fluid, which maintains proper glide of the tendon during movement without difficulty or pain.

One of the most common types of tendinitis is de quervain tenosynovitis, which is swelling of certain tendons at the base of the thumb on the side of the wrist, causing pain and limiting the ability to move the wrist.

Drawing showing the placement of the tendons of the thumb on the medial side of the wrist and their passage through the condyle of the extensors.
The tendons of the two muscles are located on the medial side of the wrist at the base of the thumb.

De Quervain's syndrome affects the extensor brevis and abductor longus muscle. These muscles are located on the dorsal side of the forearm and travel lateral to the thumb through a fibrous-bony tunnel at the wrist called the extensor reflex.

The length of the cuff is about 2 cm, so it is at risk of snagging, especially in the event of blunt force trauma or repetitive movement.

De Quervain's inflammation affects adults between the ages of 40 and 50. This condition affects women 8 to 10 times as often as men, and is common in people with a history of medial or lateral epicondylitis.

Causes of thumb tendonitis 

 The exact cause of thumb tendonitis is unknown
Thumb tendinitis can be caused by several factors, including:

  • Overuse
  • A direct blow to the thumb, which leads to the formation of scar tissue that impedes the movement of the tendons
  • Long-term physical activities such as running
  • The presence of an inflammatory condition in the body, eg Rheumatoid Arthritis
  • Fluid retention, which occurs in pregnant women due to hormonal changes during pregnancy

In addition, activities that require moving the wrist sideways while gripping the thumb aggravate the inflammation, and this is what happens in sports and daily activities such as:

  • Racquet sports and tennis
  • Use the hammer 
  • sewing
  • Raising young children
  • playing piano

Symptoms of thumb tendonitis 

Symptoms of de Quervain's tendinitis can include:

  • Side pain in the wrist below the base of the thumb
  • wrist pain 
  • Mild swelling or redness and warmth in the wrist
  • A fluid-filled cyst forms near the thumb
  • Crackling or popping sensation in the wrist when bending the thumb

Diagnosis of thumb tendinitis 

To diagnose thumb tendonitis, the doctor examines the hands to see if the patient feels pain when pressing the wrist or not.
Finkelstein test

The doctor may perform this test to detect tenosynovitis, in which the thumb is flexed at the wrist toward the ulna and covered by the remaining four fingers, then the wrist is flexed toward the ulna. 

Finkelstein test for thumb tendinitis

A positive result of the test causes pain along the path of the affected tendon.

Thumb tendinitis treatment 

The type of treatment appropriate for the patient depends on the age of the injury, how bad the symptoms are, and is divided into conservative management, self-care, and surgical treatment.

The treatment of thumb tendinitis aims to reduce pain and swelling, preserve the motor function of the wrist, and prevent a recurrence of the inflammation.

The amount of time it takes for symptoms to improve or go away varies from person to person, depending on the nature of the patient's activities and health condition.

Conservative treatment aimed at relieving the pain of hallux neuritis includes:


Wearing splints to rest and prevent movement of the wrist and thumb. A thumb splint is usually worn for four to six weeks. 

Thumb splint for de Quervain's syndrome
Thumb splint for patients with thumb tendonitis

Ice compresses 

Putting ice on the sore thumb and wrist area for 10 minutes every 4 to 6 hours approximately helps reduce associated swelling.


Take NSAIDs such as naproxen, diclofenac, and ibuprofen to reduce pain and inflammation.

steroid injection

If symptoms persist and previous treatments fail, a doctor may inject corticosteroids into the tendon sheath. In about 70% cases, the injection helps relieve pain and swelling for a few weeks or months.

Herbal treatment of thumb tendonitis

The treatment of de Quervain's inflammation with natural herbs is characterized by the lack of side effects associated with its ability to relieve mild to moderate pain, and these herbs include: white willow, ashwagandha, turmeric, and arnica plant.

Surgical treatment of thumb tendonitis 

The doctor recommends surgery to treat thumb tendinitis in the following cases:

  • Persistent pain along the tendon sheath
  • Suffering while moving despite trying traditional methods
  • The patient's lack of response to pain relievers
  • Symptoms worsening

De Quervain's tendon surgery: 

It is an outpatient procedure usually performed under local anesthesia or with light sedation.

During the surgery, a small incision is made in the sheath that the tendons pass through. This allows more room for the tendons to slide easily through the sheath.

The goal of this surgery is to eliminate pain and swelling and restore movement of the thumb and wrist within the normal range.

Side effects of de Quervain surgery:

  • A painful and unsightly postoperative scar is formed for several weeks, as a result of the gently displaced nerve branches of tunnel vision
  • Temporary numbness in the back of the hand or thumb 
  • Infection (lower risk of 1%)
  • stiffness and stiffness;

Upon recovery, the doctor will recommend doing wrist-strengthening exercises under the supervision of a physical therapist.

Prevention of thumb tendonitis

Thumb tendonitis can be prevented by changing activities that cause pain, taking periods of rest, avoiding activities that aggravate the condition, trying to diversify hand movements instead of taking a fixed position for long periods.

Learn more about thumb tendonitis and its treatments Contact us.


  1. Physiopedia
  2. BSSH
  3. National Library of Medicine
  4. Cleveland Clinic

Common questions

De Quervain's tendonitis is a common and not serious inflammatory problem. In some cases, the thumb can heal within a few weeks. However, tendinitis can also be a painful nuisance that disables the use of the hand. The pain can be relieved by taking painkillers and resting.

Inflammation of the tendons in the thumb is medically known as synovitis. It is a disease in which the patient suffers from pain that extends along the two tendons in the wrist, especially when grasping something and bending the wrist repeatedly.

Vitamin A contains a high percentage of collagen, which contributes to strengthening connective tissues, including tendons, bones and cartilage in the human body. It can be obtained from its natural sources such as carrots or from nutritional supplements under medical supervision.

Make an appointment with Dr. Çetin Işık
In Istanbul

Make an appointment with Dr. Çetin Işık
In Istanbul