Struggling with wrist pain near your thumb? It could be De Quervain’s tenosynovitis—a frustrating condition that makes simple tasks feel impossible. The good news? Physiotherapy is a game-changer for recovery. In this blog, we break down causes, symptoms, treatment options, and share a real success story from our clinic.

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What is De Quervain’s Tenosynovitis?

De Quervain’s tenosynovitis is a condition affecting the tendons on the thumb side of your wrist. Specifically, it involves inflammation of the sheath (synovium) that surrounds the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. These tendons are responsible for moving your thumb away from your hand, and when inflamed, even daily activities can become painful.

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Why De Quervain’s tenosynovitis Happen?

De Quervain’s tenosynovitis is often caused by repetitive wrist or thumb movements. This includes lifting a baby, texting, typing, wringing clothes, or even long hours of scrolling on your phone.

Some common contributing factors include:

• Overuse or repetitive strain (common in new parents – “Mummy’s thumb”)
• Sudden increase in hand activity
• Wrist trauma or direct injury
• Inflammatory conditions like rheumatoid arthritis
• Pregnancy and hormonal changes, which can lead to fluid retention around tendons

Similar symptoms can present with wrist tendonitis, read HERE for more information.

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Symptoms to Watch Out For

The hallmark symptom of De Quervain’s is pain on the thumb side of the wrist, especially when:

• Lifting objects (like a kettle or baby)
• Making a fist
• Turning keys or opening jars
• Moving the thumb or wrist side to side

You may also notice:

• Swelling near the base of the thumb
• A catching or snapping feeling with thumb motion
• Weak grip strength

One simple test we often use in clinic is Finkelstein’s Test. You tuck your thumb into your palm, wrap your fingers over it, and bend your wrist toward your little finger. If this brings on sharp pain near your wrist/thumb—De Quervain’s tenosynovitis is likely the culprit.

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How Physiotherapy Can Help

The good news? Most cases of De Quervain’s respond extremely well to physiotherapy—often avoiding the need for injections or surgery.

Here’s how we manage it:

1. Education & Activity Modification

We help you identify the repetitive movements contributing to the problem and guide you on how to change or temporarily avoid them.

2. Splinting or Bracing

A thumb spica splint is often used short-term to rest the tendons. We’ll advise on how long to wear it based on your symptoms and lifestyle.

3. Manual Therapy

Your physio may use techniques like soft tissue massage, joint mobilisation, or dry needling (where appropriate) to reduce tension and improve circulation.

4. Therapeutic Exercises

We introduce gentle mobility and strengthening exercises that are progressive and safe. These restore tendon glide, reduce irritation, and build resilience.

Early stage examples:

• Wrist and thumb stretches
• Isometric holds for the thumb muscles

Later stage examples:

• Eccentric strengthening
• Grip training
• Functional movement retraining

5. Taping Techniques

We often use Kinesio taping to offload the irritated area and support tendon movement during daily tasks.

6. Load Management & Graded Return

As symptoms settle, your physio will guide you through a gradual return to normal activities, ensuring you don’t overload the area again.

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Real Patient Success Story: Olivia, 33

Olivia, a local mum of two from Lane Cove, came into our clinic in distress. She had developed wrist pain after months of lifting and breastfeeding her newborn. Simple things—like lifting a coffee cup or pushing a pram—started to feel unbearable.

At her first appointment, we confirmed De Quervain’s tenosynovitis with clinical testing. Olivia was worried about needing a cortisone injection or surgery, but wanted to try conservative treatment first.

We began with education and fitted her with a soft thumb splint to wear during high-use activities. Manual therapy reduced her muscle tension and improved thumb mobility. Over a few sessions, we introduced mobility exercises, then gradually built up strength in her wrist and thumb. We also taught her better lifting techniques to reduce load on the wrist.

Within six weeks, Olivia had significant pain reduction and was back to doing the school run, lifting her baby, and even carrying grocery bags—pain-free. No injections needed.

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When to Seek Help

Don’t wait for wrist pain to become unbearable. The sooner you address De Quervain’s, the quicker it resolves. Physiotherapy is most effective when started early—especially before the inflammation becomes chronic.

If you’re experiencing:

• Ongoing thumb-side wrist pain
• Difficulty gripping or lifting
• Clicking or catching in the wrist/thumb

It’s time to book in with a physio.

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FAQs About De Quervain’s Tenosynovitis

Q: Can De Quervain’s heal on its own?
A: Sometimes, mild cases improve with rest—but more often than not, the condition lingers without proper treatment. Physiotherapy speeds up recovery and prevents recurrence.

Q: Do I need an ultrasound or MRI to diagnose it?
A: Not always. De Quervain’s is typically diagnosed clinically. Imaging may be recommended if symptoms persist or the diagnosis is unclear.

Q: Will I need a cortisone injection?
A: In some stubborn cases, injections can help. But many patients (like Olivia!) improve with physiotherapy alone and avoid the need for needles altogether.

Q: Can I still exercise?
A: Yes—but you may need to modify your routine. We’ll show you how to keep moving without aggravating the wrist.

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Prevention Tips

Once your pain settles, keep your wrists happy by following these tips:

• Avoid repetitive strain: Take breaks during tasks like typing, texting, or gardening
• Lift smarter: Use two hands and keep your wrist neutral
• Strengthen regularly: Maintain wrist and thumb strength with targeted exercises
• Warm up before exercise: Particularly before weight training or racquet sports
• Seek early treatment: Don’t let pain linger—early physio intervention is best

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Final Thoughts

De Quervain’s tenosynovitis can be painful, but it’s absolutely treatable. With the right guidance, hands-on care, and targeted exercises, you can return to your daily life pain-free and confident.

Don’t let thumb-side wrist pain stop you. Give us a call today on 9806 3077, or book online—just CLICK HERE.

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References & Further Reading

• Physiopedia – De Quervain’s Tenosynovitis
• Mayo Clinic – De Quervain’s Tenosynovitis
• Our blog on Dry Needling
• Our blog on Hand and Wrist Physiotherapy