Generated image of the wrist with a hotspot at the base of the thumb, showing the common area of symptomsDe Quervain's is a painful condition affecting the tendons on the side of the wrist at the base of the thumb. Pain, which is the main complaint, gets worse with gripping activities and movement of the wrist and thumb. Swelling can sometimes be present at the base of the thumb and wrist. 

  • Pain is commonly located where your forearm joins the base of your thumb
  • 0.5% of men and 1.3% of women report having De Quervain's
  • Its most common among individuals between the ages of 40-50 years 
  • More commonly found in people with other tendon issues, such as tennis elbow/golfers elbow 
  • New mothers or child care providers often experience symptoms in both hands, but these symptoms usually subside once the child is lifted less often

Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.

Further tests such as Ultrasound scans or x-rays may be performed if the Health Care Professional needs further information to finalise the diagnosis.

The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments. But can also include:

  • Reducing any activity that makes the pain worse, most often gripping/grasping activities
  • Use of a thumb Spica/support during the night time and during aggravating activities. You can buy a thumb spica online or from pharmacies
  • Use of Anti-inflammatory gels/medications

Once your pain is under control, working on the movement and strength of your thumb is what will help long term.  

You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your thumb to get you started.

 

It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.

The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.

 

Moving image of someone sat down with their hand on a table. They are trying to lift their thumb out to the side, but pushing it back with their other handIsometric thumb extension

Sit upright in a chair with your forearm and palm flat on the table and the tip of your thumb fully bent. Place a finger from your opposite hand on the back of your thumb between the knuckle and end joint of your thumb. Try to lift your thumb back from the table, using your opposite hand to resist the movement. Try to hold this position without moving, making sure that you keep the tip of your thumb bent.

 

Moving image of someone sat down with their hand flat on a table. They are sliding their hand from side to sideIsometric wrist radial deviation

Start in a seated position with your forearm resting on a table and your palm facing down. Place your other hand by the thumb side of your affected hand. Attempt to turn your hand inwards, whilst resisting the movement with your good hand. Ensure you keep your forearm still and the palm of your hand in contact with the table. Hold this position.

 

Moving image of someone sat down with their hand on a table. They are rotating their thumb in a circle​​​​​​​Thumb circumduction

Sit upright in a chair. Place your forearm and hand on a table with your hand on its side. Keeping your fingers and the tip of your thumb straight, move your thumb in a circular motion. Create as big a circle as you can with your thumb and try to move it in both directions.​​​​​​​

You should see a Health Care Professional if you: 

  • Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
  • Have pain that has rapidly deteriorated or suddenly worsened despite self help
  • Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
  • Feel unwell, have a fever, or unexplained weight loss
  • Are experiencing significant and regular changes to your usual sleeping pattern
  • Have any tingling or loss of sensation in your hand or wrist 
  • Notice changes to your grip strength and are frequently dropping things
  • Have severe pain after trauma, such as a fall, collision, or impact to the wrist or hand
  • Notice your thumb becomes acutely red hot and swollen without any prior explanation of activity/overuse  

If you do not have any of the above, you may be able to effectively self manage your condition

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