De Quervain's Tenosynovitis

De Quervain’s tenosynovitis is the painful inflammation of certain tendons in the thumb. Seen more in adults than children, the condition is sometimes called “caregiver’s wrist.”

However, activities common among children and teens can lead to de Quervain’s tenosynovitis. This has earned new nicknames for the condition: “Texter’s thumb” and “gamer’s thumb.”

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What are the signs and symptoms of de Quervain’s tenosynovitis?

  • Gradual or sudden onset of pain, including:
    • Pain when moving or twisting the wrist
    • Pain along the thumb side of the wrist
    • Worsening pain with use of the hand or thumb
    • Pain that travels to the thumb or from the wrist to the forearm
    • Pain or difficulty moving the thumb, especially when grasping or pinching
  • Snapping/popping sensation in the wrist with thumb movement
  • Impaired thumb function
  • Decreased grip function
  • Possible noise with wrist or thumb movement (e.g., pop, creak or crackling)

What causes de Quervain’s tenosynovitis?

  • Repetitive overuse (e.g., texting, typing or knitting)
  • Repetitive activities requiring grip and sideways wrist motion (e.g., skiing, heavy lifting or gaming)
  • Inflammatory conditions (e.g., rheumatoid arthritis)
  • Direct wrist injury

How is de Quervain’s tenosynovitis diagnosed?

In most cases, doctors can diagnose de Quervain’s tenosynovitis with a physical exam.

The test most often used for diagnosis is the Finkelstein test. It involves a series of movements to check for noticeable pain in the wrist/arm from the thumb.

How is de Quervain’s tenosynovitis treated?

Treatment depends on the extent of your child’s condition. There are several non-surgical options to treat de Quervain’s tenosynovitis:

  • I.C.E. – Rest, ice, compression and elevation
    • Heat may also be used in place of ice
  • Activity modification or restriction
  • Anti-inflammatory medication (e.g., ibuprofen)
  • Splint or brace
  • Physical therapy
  • Steroid injections

Surgery is only necessary in more severe cases if other treatment options are ineffective. Doctors at Connecticut Children’s can determine the right plan to treat your child’s de Quervain’s tenosynovitis.