De Quervain's Tenosynovitis: Signs You Have It and Exercises for Relief
Learn about de Quervain's tenosynovitis and what can cause it, plus exercise tips for relief recommended by physical therapists.
You might be a new mom lifting up your baby or an avid texter about to reply to yet another incoming message when you feel a sharp pain along the side of your wrist that’s closest to your thumb. The pain might even extend up your forearm to your elbow. What’s happening?
Unless you recently fell and landed on your wrist, a likely explanation is de Quervain’s tenosynovitis — aka wrist tenosynovitis or “mommy thumb,” says Laura Reising, PT, DPT, a physical therapist at Hinge Health.
This relatively common problem happens when the tendons that run down the thumb side of the wrist become swollen and inflamed. Fortunately, there are many things you can do to ease the discomfort.
Here, learn more about de Quervain’s tenosynovitis — and find out how to feel better with tips from our Hinge Health physical therapists.
Our Hinge Health Experts
Laura Reising, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
What Is De Quervain’s Tenosynovitis?
De Quervain’s tenosynovitis, named after the surgeon Fritz de Quervain who first described this problem, refers to an irritation of the two main tendons — the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) — that help you straighten your thumb or move it away from your index finger.
The APL and EPB tendons start in your forearm and run down your wrist all the way to your thumb. They travel together from the forearm through a tunnel-like membrane called a sheath. Normally, these rope-like tendons glide easily through this sheath, but with de Quervain’s, the tendons or the sheath (or both) become swollen. The result is that the tendons no longer have enough space to move smoothly through the sheath, which can result in pain and irritation.
People who have this problem often notice that the pain intensifies when they make a fist, grip an object, or even just rotate their wrist, says Dr. Reising. It can be more common in people who frequently pick up a baby or toddler, play racket sports, or engage their wrists in repetitive motion for another reason — perhaps because of texting, doing martial arts, gardening, or styling hair.
Symptoms of De Quervain’s Tenosynovitis
Wrist pain is the most common symptom of de Quervain’s tenosynovitis, says Dr. Reising. Symptoms typically include:
Pain on the side of your wrist closest to your thumb. “It can feel pretty sharp when it’s irritated,” says Dr. Reising, but some people first notice a soreness that later gets worse.
Swelling near the base of the thumb.
Numbness in the thumb and index finger.
A feeling that the thumb is catching, or a snapping noise when you try to move the thumb. “This happens because the area the tendons need to move through gets tight,” says Dr. Reising.
Anyone can get de Quervain’s tenosynovitis, but you may be at higher risk if you fall into one or more of the following categories:
You’re a woman between the ages of 30 and 50.
You’re pregnant or have a baby or toddler at home, or you’re a childcare worker who frequently picks up kids.
You often engage in repetitive wrist motions, perhaps because you play a racket sport, knit, garden, or do chores or repairs
You have a type of inflammatory arthritis, such as rheumatoid arthritis.
While you may not be able to change some of these risk factors, it doesn’t mean you’re destined to get de Quervain’s tenosynovitis, or if you do, that you’ll have to deal with it forever. You can do a lot to manage the symptoms, treat the problem, and prevent reinjury.
De Quervain’s Tenosynovitis: A Hinge Health Perspective
Your first instinct when you experience pain in your wrist and thumb may be to limit movement. But that’s outdated thinking. Movement is one of the best things you can do to help ease the symptoms of de Quervain’s tenosynovitis. General activity and more targeted, gentle exercises for your wrist, arm, and hand (more on that below), can play a big role in allowing you to maintain and improve your wrist and hand mobility.
Simple modifications can help you continue to stay active with less pain. Walking, biking, running, and other lower body workouts can be great options. For upper body work, small changes can make a big difference. For instance, changing the way you grip dumbbells or resistance bands (by bringing your thumb next to your index finger instead of wrapping it over your fingers to create a closed grip) can make them easier to use.
Treatment Options for De Quervain’s Tenosynovitis
Treating de Quervain’s tenosynovitis focuses on easing inflammation in the wrist area as well as learning techniques to avoid irritating the area in the future, says Dr. Reising. Some options:
Bracing. A wrist brace that also stabilizes your thumb can help prevent further irritation and give the inflammation in your tendons a chance to calm down, says Dr. Reising.
Ice. It may help numb the pain and bring down swelling. Try icing your wrist for up to 20 minutes at a time, and remember to keep a barrier (like a washcloth) between the ice and your skin.
Over-the-counter medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful. It’s important to make sure that you are safely able to take these medications, based on your medical history.
Activity modification. Changing the way you grip can be crucial for recovering as well as avoiding re-injury. A physical therapist can educate you on how to tweak your habits for this purpose, says Dr. Reising. For instance, a mom who’s been picking her baby up by putting her thumb under the baby’s armpit might be instructed to instead keep one hand under the baby’s bottom and another behind the head. Someone who uses their phone a lot might benefit from using voice commands or phone or video chatting instead of texting, at least some of the time.
Physical therapy. “Physical therapy is a great way to treat de Quervain’s as well as prevent it from getting worse,” says Dr. Reising. You’ll learn how to strengthen the muscles in the thumb, fingers, hands, and wrist, all the way up the forearms (which is where the irritated tendons originate). “Muscles often get weaker when you’re in pain, so you need to strengthen them and build up tolerance to gripping and pinching movements,” says Dr. Reising. Increasing flexibility with stretches is also key. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.
Exercises for De Quervain’s Tenosynovitis
Hinge Health physical therapists often recommend the above moves for de Quervain’s tenosynovitis because movement brings blood flow to the area to expedite healing. These moves also improve the mobility of the irritated tendons and strengthen the surrounding muscles to help get you back to the daily activities you enjoy.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
PT Tip: Use Props to Ease Pain
If you have pain when holding a book, try using a book stand. “That way you can continue to enjoy reading but take some stress off the thumb and wrist area,” says Dr. Reising. To ease the ache of scrolling on your phone, try attaching a ring or pop-up grip; it will change the way you hold the device, she adds.
How Hinge Health Can Help You
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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