🏥 Gotokuji Orthopedic Clinic / Patient Guide

De Quervain's Tenosynovitis

A common cause of pain at the base of the thumb and wrist — also known as "smartphone tenosynovitis"

In De Quervain's tenosynovitis the tendon sheath around the tendons that move the thumb becomes thickened and stiff, narrowing the tunnel the tendons run through. Despite the name, tissue studies show thickening and degeneration of the sheath rather than true inflammation.
It causes pain and swelling on the thumb side of the wrist, often worsened by smartphone use, typing, or lifting a baby.
It is especially common in women during pregnancy, the postpartum period, and around menopause.

1
Overuse of the thumb and wrist

Repetitive motion from phones, computers, holding a baby, or instruments stresses the tendons

2
Friction and microtrauma in the sheath

Smooth gliding is lost and tiny injuries develop on the tendon surface

3
Inflammation narrows the tunnel

The swollen sheath squeezes the tendon, making every motion painful

4
Stiffness and chronic pain

If left untreated, catching and weakness can interfere with daily life

📱 Heavy smartphone use 💻 Desk work 👶 New parents 🤰 Pregnancy / postpartum 🌸 Menopause 🎻 Musicians / crafts
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Pain at the base of the thumb and wrist
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Sharp pain when moving the thumb
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Swelling on the thumb side of the wrist
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Stiffness or pain in the morning
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Pain when pinching, lifting a baby, or wringing out a towel
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Rest & Splinting
A thumb-spica brace or taping rests the tendons
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Oral NSAIDs
Anti-inflammatory medication eases pain and swelling. NSAIDs must not be used if you have a peptic ulcer or have ever had an asthma attack triggered by a painkiller (aspirin-induced asthma)
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Topical Gel / Patch
Diclofenac or loxoprofen applied directly to the area
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Steroid Injection
A targeted injection has been reported to help about 70–80% of patients. It is not given if there is infection at or around the injection site. Repeated injections can weaken the tendon and cause it to rupture, so injections are spaced at least 2 weeks apart and kept to a limited number
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Rehabilitation
Stretching and graded loading prevent recurrence
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Surgical Release
For stubborn cases, surgery widens the sheath. We do not perform surgery here, so we refer you to a partner hospital
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Most cases improve with conservative care over weeks to months

Early rest often relieves symptoms within 1–2 weeks. When a steroid injection is needed, the success rate is high. Even after surgery, patients usually return to daily activities within 1–2 weeks. Reviewing how you use your hands is key to preventing relapse.

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When to see a specialist.
If pain lasts more than 1–2 weeks, doesn't respond to over-the-counter medication, or thumb movement keeps getting worse, please come in. A Finkelstein test plus ultrasound confirms the diagnosis, and an injection can often be performed the same day.

💡 4 Things to Remember

  • Use both hands on your phone — avoid one-thumb operation
  • Take a short break and stretch every 30–60 minutes
  • Carry babies and bags using your forearms and trunk, not your wrists
  • "Pushing through the pain" is a major cause of worsening — early care is recommended