De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is an irritation of the tendons on the thumb side of the wrist. The two tendons that control thumb movement (abductor pollicis longus and extensor pollicis brevis) pass through a tight tunnel at the wrist — when they become inflamed or thickened, they cause pain and tenderness at the base of the thumb.
It’s particularly common in new parents (often called “mummy thumb” or “daddy thumb”) because of the repeated awkward wrist positions used to lift and carry babies.
Common Causes
- Repeated lifting with the thumb out and wrist bent (lifting a baby, equipment, boxes)
- Repetitive pinching and gripping — trades, knitting, gaming
- Sudden increase in activities involving thumb use
- Pregnancy-related fluid retention that swells the tendon sheath
- Rheumatoid arthritis
Symptoms
- Pain, tenderness and sometimes visible swelling on the thumb side of the wrist
- Pain that worsens when gripping, pinching or making a fist
- A creaking or catching sensation with thumb movement
- Positive Finkelstein test (thumb tucked inside fist and wrist bent — reproduces the pain)
- Difficulty with daily tasks like picking up objects, opening jars or turning keys
Treatment
Short-Term Management
- Thumb spica splinting to rest the tendons (particularly important in the acute phase)
- Activity modification to reduce provocative movements
- Ice for pain management
Physiotherapy
- Soft tissue massage and mobilisation of the extensor compartment
- Kinesio taping to offload the tendons and reduce swelling
- Progressive strengthening of the thumb and wrist once symptoms settle
- Ergonomic advice for baby care, work setup or sporting equipment
When to Consider Injection
Corticosteroid injection into the tendon sheath can quickly settle acute, severe flares. Physiotherapy should follow to address the underlying cause and prevent recurrence.
In New Parents
We understand the difficulty of resting when you have a newborn to care for. We’ll work with you on realistic strategies — including taping techniques and modified lifting methods — that allow you to keep caring for your baby while the tendons heal.
