De Quervain’s Tenosynovitis Treatment

Are you experiencing sharp pain in your thumb every time you lift your newborn? Or maybe you feel discomfort when gripping objects with your thumb? You’re likely dealing with De Quervain’s tenosynovitis, a common condition affecting the thumb and wrist that we see frequently here in New York.

De Quervain’s tenosynovitis is sometimes called “mommy thumb” because we often diagnose it in new mothers throughout NYC. In general, it affects more women than men, with studies showing the condition occurs in 1.3% of women compared to 0.5% of men.

Whether you’re a new parent juggling life in the city or someone dealing with thumb pain from your daily activities, the specialists at New York Bone & Joint Specialists can successfully treat your De Quervain’s tenosynovitis. We start with conservative therapies, and as one of New York’s leading orthopedic facilities, we’re here if you need surgical intervention.

Understanding De Quervain’s Tenosynovitis: What’s Happening in Your Thumb

What is De Quervain’s Tenosynovitis?

De Quervain’s tenosynovitis occurs when the tendons connecting the base of your thumb to your arm become inflamed or swollen. Think of tendons as strong, flexible cords that attach your muscles to bones and help your joints move smoothly. These tendons are covered by a thin, slippery sheath called synovium that normally allows them to glide freely.

When your tendon or its covering becomes irritated or constricted, the tendons swell up, restricting movement in your thumb and causing the pain and swelling you’re experiencing.

This condition is especially common among new parents, usually from carrying your little one for long periods. We also see it frequently in people who use their thumbs regularly, like musicians and gamers. That’s why you might also hear it called “gamer’s thumb.”

Signs You Might Have De Quervain’s Tenosynovitis:

Pain is the main symptom, but it has some distinctive patterns you can recognize:

• Sharp pain at the base of your thumb that may start gradually or suddenly
• Pain that travels from your thumb up to your forearm
• Discomfort when you grip or pinch objects or make a fist
• Swelling around the thumb side of your wrist that makes it difficult to move
• A snapping sensation when you move your thumb

The Finkelstein Test—Try This at Home:

Here’s a simple test we use to help diagnose De Quervain’s tenosynovitis:

1. Make a fist with your fingers wrapped over your thumb
2. Hold the fist and bend your wrist toward your little finger
3. If you feel pain on the thumb side of your wrist, you likely have De Quervain’s tenosynovitis

What’s Causing Your Thumb Pain?

While medical professionals aren’t entirely sure what causes De Quervain’s tenosynovitis, we’ve identified several risk factors that might apply to your situation:

Common Triggers:

• Repetitive actions: Whether you’re playing tennis in Central Park, using tools for work, playing string instruments, or spending hours gaming
• Injury: Previous trauma to the tendon that caused scar tissue
• Inflammatory conditions: If you have arthritis or rheumatoid arthritis, you’re at higher risk
• Pregnancy: Fluid retention from pregnancy hormones can lead to swelling in your thumb

Are You in a High-Risk Group?

You might be more likely to develop this condition if you’re:

• A new parent who frequently lifts and holds your baby
• A gamer or heavy smartphone user (especially common among younger New Yorkers!)
• A musician who plays string or percussion instruments
• An athlete who plays racquet sports
• Someone who works with your hands and tools
• Over 40, particularly if you’re female
• An office worker who types and uses a mouse for long periods
• A childcare worker who lifts children regularly

“Mommy Thumb”—Why New Parents Are Especially Affected:

If you’re a new mom or dad in New York, you’re not alone in experiencing this. De Quervain’s tenosynovitis typically starts about four to six weeks after delivery, though it can begin during the later stages of pregnancy when hormonal changes cause swelling.

After your baby arrives, you’re lifting them numerous times throughout the day—into cribs, car seats, strollers for walks around the neighborhood. This repeated lifting strains your thumb tendons. The awkward positioning while breastfeeding can also contribute to the problem.

When Should You See a Doctor?

You should consult with one of our specialists if you’re experiencing:

• Persistent pain that’s lasted a few weeks
• Pain and swelling that doesn’t improve with rest, ice, or over-the-counter anti-inflammatory medications
• Difficulty performing daily activities like grasping your coffee cup or typing at work

How We’ll Diagnose Your Condition:

At New York Bone & Joint Specialists, our orthopedic team takes a comprehensive approach to diagnosis:

• We’ll review your health history and discuss when your symptoms began
• We’ll ask about which activities cause you pain
• We’ll perform a physical exam of your thumb to assess swelling and pain levels
• We’ll do the Finkelstein test (the same one you can try at home)
• If necessary, we’ll order imaging tests like X-rays or MRIs to rule out other causes of your wrist pain

Your Treatment Options: Getting You Back to Pain-Free Living

Conservative Treatments We’ll Start With:

Rest and Activity Changes: We’ll help you identify and avoid repetitive motions that increase your pain. This means temporarily avoiding pinching with your thumb or moving your wrist side to side.

Splinting: A forearm spica splint will immobilize your thumb and wrist, taking pressure off the tendon so it can heal. We typically recommend wearing it at night.

Ice Therapy: Apply ice to your wrist and thumb for 20 minutes several times a day to reduce swelling.

Pain Management: Over-the-counter anti-inflammatory drugs like ibuprofen and naproxen will help reduce swelling and inflammation.

Physical Therapy: Our physical therapists will guide you through exercises specifically designed to alleviate your thumb pain and stiffness.

Exercises You Can Do at Home:

Here are some gentle exercises to help with your recovery. Remember to do these slowly and don’t push past pain:

Thumb Flexion and Extension:

1. Place your affected hand on a table with your thumb pointing up
2. Bend your thumb downward across your palm until it touches the base of your little finger
3. Hold for six seconds, then straighten your thumb
4. Repeat 8-12 times

Thumb Extension for Tendon Gliding:

1. Start with your hand relaxed, palm up
2. Extend your thumb away from your palm and fingers
3. Hold for a few seconds, then slowly return to the starting position
4. Repeat 10-15 times

Wrist Movement:

1. Hold your arm out in front of you, palm down
2. Move your wrist toward your thumb, then toward your pinky finger
3. Hold each position for a few seconds
4. Repeat 10-15 times

Strengthening Exercise:

1. Grip a tennis ball lightly for a few minutes
2. Rest, then repeat with slightly more pressure if you don’t feel pain

If Conservative Treatment Isn’t Enough:

Steroid Injections: If the treatments above don’t provide relief, we may suggest a corticosteroid injection into your tendon sheath to reduce inflammation and improve function. This can be especially effective if we administer it within six months of when your symptoms started.

When Surgery Might Be Your Best Option

Surgery is rarely needed, but we may recommend it if:

• Conservative treatments haven’t resolved your pain after several weeks
• Steroid injections only provide temporary relief
• You can’t perform daily activities due to severe pain
• Your quality of life is significantly impacted

What to Expect from Surgery:

Our tendon sheath release procedure is a 30-minute outpatient surgery, meaning you’ll go home the same day:

1. We’ll numb the area with local anesthesia
2. We’ll make a small incision at the base of your thumb
3. We’ll carefully cut the top of the tendon sheath to release tension, allowing the tendon to glide freely
4. We’ll stitch and bandage the site

Your Recovery Process:

• Keep your hand elevated and immobile for 2-3 days
• Apply cold compresses for 10-15 minutes at a time
• Avoid straining your wrist or lifting heavy objects for 1-2 weeks
• Keep the dressing dry until we remove your stitches in 1-2 weeks
• Start physical therapy after stitch removal
• Expect full recovery in 6-8 weeks

Preventing Future Problems

While we can’t pinpoint an exact cause for De Quervain’s tenosynovitis, here are steps you can take to keep your wrists and thumbs healthy:

At Work:

• Set up your desk, chair, and computer so your wrist and thumb stay in a neutral position
• Consider ergonomic mice, keyboards, pens, and scissors
• Take frequent breaks from repetitive work

In Daily Life:

• Take breaks from your smartphone—try voice-to-text features
• Exercise your wrists regularly with simple movements like thumb rotations
• If you’re a new parent, vary how you hold and lift your baby
• Seek treatment early if you notice symptoms

Why Choose New York Bone & Joint Specialists?

As New Yorkers ourselves, we understand the demands of city life and how thumb pain can interfere with everything from your subway commute to caring for your family. Here’s what sets our team apart:

• Board-certified specialists with advanced training in hand and wrist conditions
• Conservative treatment focus—90% of our patients recover fully without surgery
• Patient-centered approach that considers your lifestyle and needs
• State-of-the-art diagnostic tools for accurate diagnosis
• Minimally invasive surgical options when surgery is needed
• Comprehensive rehabilitation with customized physical therapy programs

Frequently Asked Questions

What kind of doctor should I see for De Quervain’s tenosynovitis?

Orthopedic hand specialists like our team at New York Bone & Joint Specialists have the advanced training to diagnose and treat this condition effectively. If home care isn’t helping your pain, we’re here to create a treatment plan that gets you back to your normal activities.

How long will it take to heal?

With conservative treatment, you can expect relief in several weeks, depending on what caused your condition. Following our treatment plan—avoiding straining activities, icing, doing exercises, and wearing a splint—can resolve your pain and improve mobility. Many patients find significant relief with a corticosteroid injection.

Will this go away on its own?

De Quervain’s tenosynovitis might resolve on its own if the damage isn’t severe, but you can speed your recovery significantly with proper treatment started early. Without treatment, you risk tearing the tendon and developing chronic pain.

How is this different from arthritis?

While both can cause swelling, pain, and reduced range of motion, they’re quite different. Arthritis affects the cartilage in your joint and causes aching pain. De Quervain’s tenosynovitis affects the tendons and causes sharper pain, usually when you use your thumb or wrist.

Can this come back after surgery?

Surgery has a high success rate of 85%, and recurrence is rare when you follow our post-surgery care instructions, including wearing a splint and doing physical therapy exercises.

Ready to Get Relief?

Don’t let thumb pain keep you from enjoying life in New York. Whether you’re a new parent struggling with “mommy thumb” or dealing with pain from your daily activities, we’re here to help you get back to comfortable, pain-free living.