Stenosing Tenosynovitis of the Thumb: (Hand)

De Quervain’s tenosynovitis is a condition that causes pain on the thumb side of the wrist. The pain may start suddenly, but more often it builds gradually over weeks or months. It can spread up the forearm toward the elbow. Movements like pinching, grasping, twisting, or lifting tend to make the pain worse.

Swelling is often seen at the base of the thumb, where the tendons run. Sometimes a small fluid-filled bump, called a cyst, may appear. Some people also notice a snapping or catching feeling when they move their thumb, or even a faint squeaking sound. In certain cases, irritation of a nearby nerve can cause numbness on the back of the thumb and index finger.

During an exam, your doctor will press on the outside of your wrist, near the bone on the thumb side. This area is usually tender in people with De Quervain’s. They may also check your thumb’s range of motion and pinch strength, which are often reduced.

Special movement tests are used to confirm the diagnosis. The most common is called Finkelstein’s test. In this test, you tuck your thumb into your palm and bend your wrist toward your little finger. If this brings on sharp pain, it strongly suggests De Quervain’s. Other simple tests, like resisting thumb movement, can also reproduce the pain and help guide the diagnosis.

With proper treatment and activity guidance, most people recover fully and return to their original activity level without long-term problems.