De Quervain’s syndrome (often called De Quervain’s tenosynovitis) is a common cause of pain on the thumb side of the wrist. It often appears during busy seasons of life: caring for a baby, doing more housework, typing and scrolling on the phone, or taking on hobbies that involve gripping and twisting. At first, the pain may feel like a small annoyance. Later, even simple actions—lifting a kettle, opening a jar, or picking up a child—can trigger a sharp pull along the thumb side of the wrist.
This article explains De Quervain’s syndrome in everyday language: what it is, why it happens, how it affects daily activities, and how rehabilitation and practical changes can support recovery. It focuses on understanding and realistic management, not miracle promises.
What is De Quervain’s Syndrome?
On the thumb side of your wrist, two important tendons run in a narrow “tunnel” under a small ligament:
- Abductor pollicis longus (APL)
- Extensor pollicis brevis (EPB)
These tendons help you move your thumb away from the palm and extend it, especially when gripping, lifting or twisting.
In De Quervain’s syndrome, this tendon compartment becomes irritated and sensitive. The lining around the tendons can thicken or become less smooth, and space in the tunnel feels “too tight” for the movement demanded. The result is pain, particularly when you use your thumb and wrist together in certain directions.
People typically notice:
- Pain or tenderness on the thumb side of the wrist (near the base of the thumb)
- Discomfort when lifting objects with the thumb pointing up
- Pain when turning the wrist (for example, pouring, wringing, opening jars)
- Pain when lifting a baby or child under the arms
Sometimes there is a bit of swelling or a feeling of “thickening” over that area. In more irritable stages, even small movements or accidental bumps can feel surprisingly sharp.
How De Quervain’s Syndrome Starts
De Quervain’s syndrome often begins during periods of increased or repetitive thumb-and-wrist use. Common patterns include:
- New parents repeatedly lifting a baby, especially under the armpits
- Workers doing more tasks that involve gripping and twisting tools
- People spending longer hours on phones, tablets or gaming controllers
- Hobbies such as knitting, crocheting, gardening or racquet sports, especially after a sudden increase in time or intensity
Sometimes there is a clear moment of sharp pain after a specific action. More often, the discomfort builds gradually. At first, it may appear only after a long day or heavy use and settle with rest. If the pattern continues without adjustment, the tendon compartment can become more reactive. Pain starts earlier in a task, lingers longer afterward and can appear in everyday movements that used to feel easy.
Because the pain is localised and aggravated by thumb movements, many people assume they’ve “sprained” the wrist. When symptoms persist, or when certain motions start to feel almost “electric,” they seek help and learn that it is a tendon-related problem rather than a simple sprain.
Everyday Impact: Small Area, Big Effect
Even though De Quervain’s affects a small area, the impact on daily life can be large. The thumb is involved in almost every hand task. Pain on the thumb side of the wrist can change:
- How you lift: carrying bags, pots, kettles, or a child can be painful, especially with one hand.
- How you grip: opening jars, turning keys, using tools, wringing a cloth or using scissors may trigger a sharp pull.
- How you use devices: scrolling, texting or playing games on the phone can aggravate symptoms, particularly when the wrist is bent and the thumb works repeatedly.
- Work tasks: manual jobs, hairdressing, caregiving, or any work that relies on continuous hand use may become harder.
People often start compensating with the other hand or changing the way they hold things. Some of these adaptations are helpful; others transfer strain elsewhere (for example, into the elbow or shoulder). Sleep can also be affected if certain positions or accidental twists of the wrist trigger pain at night.
Emotionally, there may be frustration or guilt—especially for parents or caregivers who feel limited in how they can carry or care for others. Knowing that De Quervain’s is common and treatable, and that it reflects overload rather than a permanent “damage,” can be reassuring.
How De Quervain’s Syndrome is Diagnosed
A proper assessment with a doctor or therapist is important to confirm that pain really is coming from the tendon compartment near the thumb and not from other structures.
During assessment, a clinician will typically:
- Ask about symptom history: when it started, what makes it worse, what helps.
- Press gently over the thumb side of the wrist to locate tender spots.
- Check wrist and thumb range of motion.
- Use specific tests that place the tendons on stretch (for example, tucking the thumb into the fist and moving the wrist towards the little finger), to see if this reproduces the familiar pain.
Imaging (such as ultrasound) is not always necessary in straightforward cases. It may be used if the diagnosis is unclear, if symptoms are not following the expected pattern, or if there is a need to consider other conditions (such as arthritis, ganglion cysts or intersection syndrome).
What matters most is that your symptoms, physical findings and daily activity pattern match the picture of De Quervain’s, so that management can be tailored appropriately.
Why Rest Alone Is Not Enough (But Overuse Doesn’t Help Either)
When the wrist is very painful, the natural reaction is to rest completely and avoid using the thumb. Short-term rest and protection can reduce irritation and give tissues breathing space. However, long-term complete rest often leads to stiffness, weakness, and increased sensitivity; it also becomes impractical in real life.
On the other extreme, ignoring pain and continuing all activities at full intensity can keep the tendon compartment irritated, making recovery slower and more frustrating.
Most people do best with a middle path:
- Short-term reduction or modification of the most provocative activities
- Gentle movement and use of the thumb within a comfortable range
- A gradual, structured increase in load as symptoms settle
This approach aims to calm things down and slowly rebuild the tendon’s tolerance, instead of getting stuck in a cycle of repeated flare-ups.
Conservative Management: What Usually Comes First
De Quervain’s syndrome is typically managed conservatively at first—without surgery. Common components include:
Activity Modification
This means looking carefully at the specific movements that provoke symptoms, and then adjusting how you do them. Examples include:
- Using two hands to lift heavier objects
- Holding babies or children closer to the body, avoiding thumb-hooked positions under the armpits
- Using built-up, larger handles or jar openers instead of strong pinch grip
- Limiting long periods of phone thumb-scrolling, or changing how you hold the device
The goal is to reduce peak stress on the irritated tendon compartment while still allowing the hand to function.
Splinting or Bracing
A thumb spica splint or soft support that holds the wrist and thumb in a neutral, rested position may be recommended, especially during aggravating activities or at night. This can help control painful movements and give the tendon a chance to settle. Splints are usually used for a period of time, not forever, and ideally alongside gradual exercises.
Pain Management
Depending on severity, doctors may suggest pain-relieving medications or topical anti-inflammatory gels. Ice or gentle heat can provide short-term relief for some people. These tools don’t “fix” the condition but can make daily life and rehabilitation more tolerable.
Targeted Exercises
Under the guidance of an occupational therapist or physiotherapist, gentle exercises may be introduced to maintain mobility of the thumb and wrist, support circulation, and gradually improve tendon load tolerance. Early on, this might be very light movements in a pain-aware range; later, more strengthening and functional tasks are added.
Consistency and gradual progression matter more than doing very “strong” exercises all at once.
Injections and Surgical Options
If symptoms are significant and do not improve with well-timed conservative strategies, a doctor may discuss corticosteroid injections into the tendon sheath. For some people, this provides meaningful short- to medium-term relief. For others, the effect is partial or temporary. Injections are not a magic cure and should be considered as one tool, with benefits and risks explained clearly.
Surgery (release of the first dorsal compartment) is usually reserved for:
- Cases that have persisted for a long time
- Symptoms that remain functionally very limiting
- Situations where conservative treatment and injections have not given sufficient relief
After surgery, a period of wound healing, gentle mobilisation and graded return to activities is important. Occupational therapy or hand therapy can be helpful in guiding this process so that the wrist and thumb resume useful roles without being overloaded too quickly.
The Role of Occupational Therapy in De Quervain’s Syndrome
Occupational therapists look at how De Quervain’s affects your daily roles and routines, not just the tendon itself. Their focus includes:
Task and Environment Analysis
An OT will explore the way you:
- Lift, carry and hold objects at home and work
- Use your phone, computer, tools and kitchen equipment
- Handle caregiving tasks like feeding, bathing, and carrying children
From there, they can suggest specific adjustments—for example, different ways to hold a baby, using trolleys instead of carrying heavy bags, or reorganising kitchen layouts so that heavier items are positioned more conveniently.
Splint Education and Use
If a splint is prescribed, OTs ensure it fits comfortably, does not interfere with circulation or skin, and can realistically be used within your routine. They will help you decide when to wear it (for example, at night or during heavier tasks) and when to gently move without it.
Graded Return to Activity
As symptoms settle, occupational therapy emphasises gradual reintroduction of meaningful tasks: work duties, childcare activities, hobbies or sports. Rather than crossing your fingers and hoping it won’t hurt, you follow a plan that lets the tendon adapt to increasing load.
This kind of structured support can make the difference between repeated flare-ups and a more stable, confident recovery.
When to Seek Further Medical Advice
Most cases of De Quervain’s develop gradually and can be assessed and managed in an outpatient setting. However, you should seek timely professional advice if:
- Pain is severe and sudden after a significant injury
- There is visible deformity, marked swelling, or signs of infection (redness, warmth, fever)
- Symptoms rapidly worsen despite sensible self-care
- Numbness or tingling suggests involvement of nerves, not just tendons
- Pain and limitation are significantly affecting work, caregiving or essential daily tasks
Early assessment does not mean you will automatically need injections or surgery, but it can clarify what is happening and help you choose a sensible plan sooner rather than later.
A Realistic and Hopeful Outlook
De Quervain’s syndrome can be surprisingly disruptive for such a small area of the body. It can interfere with work, parenting, housework and hobbies, and it often appears at times of life when your hands are needed most.
The encouraging message is that De Quervain’s is common, well-recognised, and often manageable with a combination of activity modification, splinting, graded exercises and, in some cases, medical interventions. The aim is not to stop using the hand, but to change the way it is used so the irritated tendon compartment can calm down and gradually rebuild tolerance.
With good information, realistic pacing, and support from therapists and your wider healthcare team, many people find they can return to lifting, caring and creating with far less pain—and with a better understanding of how to protect their wrists in the future.
This article is for general education and does not replace individual medical advice. For personalised assessment and recommendations, please consult your healthcare provider or rehabilitation team.
