You reach for your phone, and a sharp pain shoots through the base of your thumb. You lift your baby out of the crib, and your wrist aches. You try to open a jar, twist a doorknob, or carry a grocery bag, and the same pain stops you. It built up slowly, day after day, until simple tasks became painful.

That is De Quervain's tenosynovitis, one of the most common causes of thumb and wrist pain. It affects new mothers, office workers, tradespeople, and anyone who uses their thumb and wrist the same way, over and over again. The name is long, but the problem is simple: two tendons that move your thumb have become irritated and swollen inside a narrow tunnel at the side of your wrist.

The good news is that it responds well to physiotherapy in most cases, without surgery. This guide explains de quervain's tenosynovitis treatment in Surrey in plain language: what it is, why it happens, how to tell it apart from carpal tunnel and trigger finger, the treatment options that work, the exercises that fix it, and how long recovery takes.

What Is De Quervain's Tenosynovitis?

De Quervain's tenosynovitis is an irritation of the tendons on the thumb side of the wrist. Two tendons control the movement of your thumb: the abductor pollicis longus, which pulls the thumb away from the hand, and the extensor pollicis brevis, which straightens the thumb. These two tendons run together through a narrow tunnel at the side of the wrist, called the first dorsal compartment. The tunnel is lined with a slippery sheath that lets the tendons glide smoothly every time you move your thumb.

When you repeat the same thumb and wrist movements many times a day, the tendons and their sheath become irritated. The sheath thickens, the tunnel narrows, and the tendons no longer glide freely. Instead, they rub and catch inside the tunnel. That friction causes pain, swelling, and stiffness, especially at the base of the thumb and along the side of the wrist.

The "tenosynovitis" part simply means inflammation of the tendon sheath. It is not arthritis or a fracture. It is an overuse injury.

Causes of De Quervain's Tenosynovitis

De Quervain's tenosynovitis almost always develops gradually. There is usually no single injury. Instead, the tendons become irritated from repeated use over weeks or months. The most common causes are:

Lifting and holding a baby. This is the most common cause we see, and it is why the condition is often called "mommy thumb." New mothers lift their baby dozens of times a day, often with the thumb spread wide and the wrist bent. The baby gets heavier every week, and the tendons never get a chance to recover. New fathers get it too, for the same reason.
Phone and computer use. Scrolling, texting, and holding a phone with one hand keeps the thumb in the same position for hours. Typing with the wrist bent, or using a mouse that does not fit your hand, adds to the load.
Repetitive gripping and twisting. Any job or hobby that involves repeated gripping, squeezing, or twisting can irritate the thumb tendons. Tradespeople, gardeners, musicians, painters, and people who play racquet sports are all at risk.
A sudden increase in activity. Starting a new job, taking up a new hobby, moving house, or doing a weekend of heavy gardening can overload tendons that were not ready for the extra work.
Hormonal changes. De Quervain's is more common in women, especially during pregnancy and in the months after giving birth. Hormonal changes can cause fluid retention and swelling in the tissues around the tendons, which narrows the tunnel further.
Rheumatoid arthritis and other inflammatory conditions. People with rheumatoid arthritis or other inflammatory conditions are more likely to develop De Quervain's, because the tissues around the tendons are already inflamed. If you have arthritis, you can read our guide to arthritis treatment in Surrey to understand how physiotherapy helps inflamed joints.

Symptoms of De Quervain's Tenosynovitis

The symptoms usually start slowly and get worse over time.

  • Pain at the base of the thumb, on the thumb side of the wrist
  • Pain that gets worse when you grip, pinch, twist, or lift something
  • Tenderness when you press the thumb side of the wrist
  • Swelling along the side of the wrist, sometimes with a small visible bump
  • A catching or snapping feeling when you move your thumb
  • Stiffness in the thumb and wrist, especially in the morning
  • Pain that spreads up the forearm, or down into the thumb
  • Weakness when gripping, so you drop things more often
  • Pain when you lift your baby, hold a phone, open a jar, or turn a key

In the early stage, the pain appears only during the activity that causes it, and settles with rest. As the condition progresses, the pain can be present most of the day, and even simple tasks like brushing your teeth or buttoning a shirt can hurt.

One of the most telling signs is pain when you make a fist with your thumb tucked inside your fingers and then bend your wrist toward your little finger. That movement is called the Finkelstein test, and it is the standard way physiotherapists check for De Quervain's.

The Finkelstein Test: How Physiotherapists Check for It

The Finkelstein test is a simple hands-on test that helps confirm De Quervain's tenosynovitis. You make a fist, with your thumb tucked inside your fingers. The physiotherapist gently bends your wrist toward your little finger, stretching the thumb tendons. If that movement causes sharp pain at the base of the thumb and along the side of the wrist, the test is positive.

A positive Finkelstein test, combined with tenderness over the first dorsal compartment and a history of repetitive thumb use, is usually enough to diagnose De Quervain's. No scan is needed in most cases. X-rays are not helpful, because tendons do not show up on X-ray. An ultrasound can show the thickened sheath, but it is rarely necessary unless the diagnosis is unclear.

The Finkelstein test can be uncomfortable, so do not try to force it on yourself at home. A physiotherapist will do it gently and stop if the pain is too strong. Doing it repeatedly on your own will only irritate the tendons further.

De Quervain's vs Carpal Tunnel vs Trigger Finger

Thumb and wrist pain can come from several different conditions, and they often feel similar at first. Here is how to tell them apart.

De Quervain's tenosynovitis. Pain is on the thumb side of the wrist, at the base of the thumb. It hurts when you grip, pinch, or twist. The Finkelstein test is positive. There is usually no numbness or tingling.
Carpal tunnel syndrome. Pain, numbness, and tingling in the thumb, index finger, middle finger, and part of the ring finger. The symptoms are often worse at night and may wake you up. Shaking your hand helps. Carpal tunnel is a nerve problem, not a tendon problem. You can read our guide to carpal tunnel treatment in Surrey to learn the difference in detail.
Trigger finger. One finger, often the ring finger or middle finger, catches or locks when you bend it, and then snaps straight with a pop. The catching happens at the base of the finger in the palm, not at the wrist. Trigger finger affects the flexor tendons in the palm, not the thumb tendons at the wrist. Our guide to trigger finger treatment in Surrey explains how it is treated.
Wrist arthritis. Pain and stiffness deep inside the wrist joint, worse with movement and in cold weather, often with a grinding feeling. Arthritis affects the joint itself, not the tendons. Our guide to wrist pain treatment in Surrey covers the different causes of wrist pain, including arthritis.

It is possible to have more than one of these conditions at the same time. A physiotherapist will test for all of them during your assessment, so nothing is missed.

How Physiotherapy Treats De Quervain's Tenosynovitis

Most cases of De Quervain's improve with physiotherapy, without injections or surgery. Treatment works by calming the irritation, reducing the load on the tendons, and gradually rebuilding their strength. Here is what de quervain's tenosynovitis treatment in Surrey usually involves.

Splinting

A thumb spica splint is often the first step. This is a splint that holds the thumb and wrist still, usually for 2 to 4 weeks. It rests the tendons and stops the constant rubbing inside the tunnel. The splint is not a permanent solution, and wearing it for too long can make the thumb stiff and weak, so it is used for a limited time.

Load Management

The most important part of treatment is changing how you use your thumb. Your physiotherapist will help you find ways to do your daily tasks with less strain on the tendons. For new mothers, that might mean lifting the baby with the palms facing up and using both hands. The goal is not to stop using your hand. It is to use it differently, so the tendons get a chance to heal while you keep living your life.

Manual Therapy

Hands-on treatment can reduce pain and improve movement in the thumb, wrist, and forearm. Soft tissue release eases tight muscles in the forearm that pull on the tendons. Joint mobilisation improves the movement of the wrist and thumb joints.

Therapeutic Exercises

Exercises are the core of long-term recovery. They are introduced gradually, starting with gentle movements and progressing to strengthening as the pain settles. The exercises rebuild the strength and control of the thumb and wrist, so the tendons can handle daily loads without becoming irritated again. The home exercise section below explains the main ones.

What About Injections and Surgery?

If physiotherapy and splinting do not settle the pain after 6 to 8 weeks, a corticosteroid injection into the tendon sheath can help. The injection reduces inflammation inside the tunnel and often gives fast relief. It is done by a doctor, not a physiotherapist, and your physiotherapist can refer you if needed.

Surgery is rarely needed. It is only considered if the pain continues despite physiotherapy and injections, which happens in a small number of cases. The surgery is a minor day procedure that opens the tunnel to give the tendons more room.

Home Exercises for De Quervain's Tenosynovitis

These are general exercises your physiotherapist may teach you. Do not start them on your own if your pain is severe, or if you have not been assessed yet. Your physiotherapist will confirm which ones are safe for you and how many repetitions to do. Mild discomfort that settles within a few minutes is normal. Sharp pain, or pain that lasts for hours afterward, means you did too much.

Thumb stretch. Hold your hand out in front of you, palm facing you. Gently pull your thumb back toward your forearm with your other hand, until you feel a mild stretch at the base of the thumb. Hold for 15 to 30 seconds. Repeat 3 times, 2 to 3 times a day.
Wrist stretch. Hold your arm out in front of you, palm facing down. Use your other hand to gently bend your wrist downward, until you feel a stretch along the top of the forearm. Hold for 15 to 30 seconds. Repeat 3 times.
Thumb opposition. Touch the tip of your thumb to the tip of each finger, one at a time, making a slow round shape with your hand. Then reverse the order. Repeat 10 times.
Isometric thumb press. Rest your hand on a table, palm down. Press the tip of your thumb gently into the table, as if you are trying to push the table down, and hold for 5 seconds. Repeat 10 times.
Towel squeeze. Hold a small rolled towel in your hand and squeeze it gently, hold for 5 seconds, then release slowly. Repeat 10 times. As you get stronger, squeeze a little harder. Stop if the pain rises above 3 out of 10.
Eccentric wrist curls. Rest your forearm on a table, palm down, with your hand hanging over the edge. Hold a light weight, such as a can of soup, in your hand. Use your other hand to lift your wrist up, then slowly lower it down over 3 seconds. Repeat 10 times.

Do these exercises 2 to 3 times a day, or as your physiotherapist advises. Keep the pain below 3 out of 10 during the exercises, and make sure it settles within a few minutes after you finish. If the pain lingers for hours, you did too much, and you should tell your physiotherapist so the program can be adjusted.

Everyday Tips: Protecting Your Thumb While It Heals

Small changes in how you do everyday tasks can take a surprising amount of strain off the thumb tendons.

Lifting your baby. Scoop your baby up with your palms facing up and your forearms underneath, rather than gripping with your thumbs spread wide. Use both arms, and keep your baby close to your body.
Using your phone. Hold your phone with both hands, or rest it on a surface, instead of gripping it with one hand and scrolling with your thumb. Use voice-to-text when you can, and take breaks from scrolling.
Opening jars and bottles. Use a jar opener, or ask someone else to open it. Do not force a tight lid with your thumb and wrist. A rubber grip pad can help, but if it still hurts, stop and use a tool.
Carrying bags. Carry shopping bags on your forearm or over your shoulder, instead of gripping the handles with your thumb and fingers. Use a backpack instead of a handbag when you can.
Work setup. If you type all day, keep your wrists straight and your elbows at about 90 degrees. Use a keyboard and mouse that fit your hands. Take a short break every 30 minutes to stretch your thumbs and wrists.
Tools and housework. Use tools with larger, cushioned handles. Avoid wringing out cloths by hand. Use a mop instead of a cloth.

These changes are temporary for most people. Once the tendons have healed and the muscles are stronger, you can go back to your normal ways of doing things.

Recovery Timeline: How Long Does It Take?

Recovery from De Quervain's tenosynovitis depends on how long you have had it, how severe it is, and how well you follow the plan. Here is a general guide.

Mild cases (pain for less than 4 weeks). With splinting, load management, and exercises, most mild cases improve in 2 to 4 weeks. Many people are back to their normal activities within a month.
Moderate cases (pain for 1 to 3 months). Recovery usually takes 6 to 8 weeks. The splint is worn for the first few weeks, and the exercises are progressed gradually.
Chronic cases (pain for more than 3 months). Recovery can take 2 to 3 months, and some people need a corticosteroid injection as well as physiotherapy.
After an injection. If you have a corticosteroid injection, the pain often settles within a few days. But the injection only reduces inflammation. The exercises are still needed to fix the cause.
After surgery. Surgery is rare, but if you have it, the wound heals in about 2 weeks. Physiotherapy starts soon after, to restore movement and strength. Most people are back to normal activities within 4 to 6 weeks.

The biggest factor is how early you start treatment. If your thumb and wrist have been hurting for more than two weeks, book an assessment. Waiting rarely makes it better on its own.

When to See a Physiotherapist

Book an assessment if any of these sound familiar:

  • Thumb or wrist pain that has lasted more than two weeks
  • Pain that keeps coming back, even after rest
  • Pain when you lift your baby, hold your phone, or grip things
  • Swelling or tenderness on the thumb side of your wrist
  • A catching or snapping feeling when you move your thumb
  • Weakness when gripping, so you drop things
  • Numbness or tingling in your thumb and fingers, which may mean carpal tunnel as well
  • You have tried resting and it did not help, or the pain came straight back when you went back to normal activities
  • You are a new parent and the pain is making it hard to care for your baby
You do not need a doctor's referral to see a physiotherapist in British Columbia. You can book directly. And the best time to come is early, when the problem is still a mild irritation, not after it has been there for months. If you have elbow pain as well as thumb pain, our guide to golfer's elbow treatment in Surrey explains how forearm problems are connected.

Frequently Asked Questions

Is De Quervain's tenosynovitis the same as carpal tunnel?

No, although they can occur together. De Quervain's is an irritation of the thumb tendons on the thumb side of the wrist. Carpal tunnel is a pinched nerve in the palm side of the wrist. De Quervain's causes pain when you grip, pinch, or twist, and the Finkelstein test is positive. Carpal tunnel causes numbness and tingling in the thumb, index, and middle fingers, often worse at night. A physiotherapist can test for both during your assessment. If you have numbness, read our guide to carpal tunnel treatment in Surrey.

Do I need to wear a splint?

Most people with De Quervain's benefit from wearing a thumb spica splint for 2 to 4 weeks, especially during the activities that cause pain. The splint rests the tendons and stops the constant rubbing inside the tunnel. It is not a permanent solution, and wearing it for too long can make the thumb stiff and weak. Your physiotherapist will fit the splint, show you when to wear it, and tell you when to stop using it.

Can I still lift my baby if I have De Quervain's?

Yes, but you need to change how you lift. Scoop your baby up with your palms facing up and your forearms underneath, instead of gripping with your thumbs spread wide. Use both arms, keep your baby close to your body, and use a pillow to support their weight when feeding. Avoid lifting with one hand and a wide thumb grip, which is the movement that loads the tendons the most.

Will De Quervain's go away on its own?

Sometimes, if the cause is removed early. If you stop the activity that irritated the tendons, mild cases can settle in a few weeks. But in practice, most people cannot stop the activity that causes it, whether that is lifting a baby, typing at work, or using their phone. Without treatment, the pain often continues for months, and the tendons can become more irritated.

Will I need surgery?

Probably not. Surgery is needed in only a small number of cases, when the pain continues despite physiotherapy, splinting, and a corticosteroid injection. Most people recover with physiotherapy alone. Your physiotherapist will tell you honestly if your case is not improving as expected and a referral is needed. The key is to start treatment early, when physiotherapy has the best chance of working.

Get Your Thumb and Wrist Moving Again

De Quervain's tenosynovitis is painful and frustrating, especially when it stops you from doing simple things like lifting your baby, holding your phone, or opening a jar. But it is very treatable. The people who recover fastest are the ones who get assessed early, rest the tendons with a splint, change how they load their thumb, and follow an exercise program that rebuilds strength gradually.

If your thumb or wrist has been hurting in or around Surrey, book an assessment at Renew Physiotherapy for de quervain's tenosynovitis treatment in Surrey. We will find out exactly which tendons are irritated, explain it in plain language, and build a plan that gets you back to lifting, gripping, and twisting without pain.

Renew Physiotherapy

5722 176a Street, Surrey, BC V3S 4H2

Phone: (236) 450-0171

Email: Info@renewclinics.ca

Website: www.renewclinics.ca

Book your De Quervain's assessment today and take the first step back to pain-free hands.