®Stretching the base of the thumb
Hold your thumb with your other hand and gently stretch the base of the thumb outwards. You should feel a slight stretch, not pain.
Hold for 15–20 seconds, 8–10 repetitions3 timesMore common in women than in men; especially in those with a young baby
Ages 30–55The age range in which it is most common; it can occur at any age
3–8 weeksThe length of time given in hospital leaflets for a splint that covers the wrist and thumb
18 peopleThe size of the only trial comparing a steroid injection with a splint; the evidence is weak
What is it?
The tendons that move the thumb pass through a tunnel-like sheath on the thumb side of the wrist. When this sheath thickens and becomes inflamed, the tendons cannot glide freely, and pain appears as the hand is used.
Often no clear cause is found. Prolonged gripping with the wrist bent forwards or to the side, rapid and repeated movements of the thumb and wrist, suddenly taking up an unfamiliar activity (gardening, decorating, a new sport) or a blow to the outer side of the wrist can set it off.
Symptoms
- Pain at the base of the thumb and the side of the wrist; it can spread into the forearm
- Pain that gets worse when gripping, pinching or twisting something
- Difficulty with tasks such as pouring from a kettle or opening a jar
- Swelling or a firm lump at the painful spot
- A catching or grating feeling when moving the thumb
Why is it common in new mothers?
De Quervain’s is seen most often in women with a young baby. The reason is not fully known: both the hormonal changes after pregnancy and childbirth and the repeated lifting, carrying and feeding of the baby may play a part.
The movement that hurts most is bending the wrist to the side. That is why it is recommended to change the position of your hand and wrist in painful tasks, to take frequent breaks in tasks that involve gripping, and to avoid movements that bend the wrist sideways. When you pick up your baby, try to keep your wrists straight and spread the load across your forearms.
The first step: rest and a splint
The first step of treatment is to rest the tendons. For this, a splint that covers both the wrist and the thumb is used. Hospital leaflets in the UK give periods of between 3 and 8 weeks; one leaflet recommends wearing it day and night for six weeks and, if the pain eases, gradually coming off the splint over 2–4 weeks. The splint is removed only for showering and for the wrist movements.
Cooling the area for 20 minutes, three times a day, can reduce the pain. Ask your pharmacist or doctor about painkillers or anti-inflammatory medicines and gels.
If the splint and exercise are not enough, a steroid injection into the sheath may be considered; some people need more than one. There is very little research testing the injection: the Cochrane review could find only one trial of 18 people and rated the certainty of the evidence as very low. Surgery is rarely needed; in a day-case procedure the sheath is opened to make room for the tendons.
Treatment
- RestCutting down on tasks that increase the pain and changing the position of the hand and wrist.
- SplintA splint covering the wrist and thumb together; the hand therapist decides its type and how long to wear it.
- Cold and medicinesCold for 20 minutes three times a day; ask a pharmacist or doctor about medicines and gels.
- ExerciseStarts with gentle movements once the pain settles, moving gradually to strengthening.
- Cortisone injectionWhen other methods are not enough; the evidence is limited.
- SurgeryRarely; a small procedure that releases the sheath.
Exercises at home
Six exercises for de Quervain’s
The first three are gentle movements done once the pain starts to settle. The last three are for strengthening; they are added after the pain has clearly eased. There may be some discomfort at first, but it should not last more than a few hours; if it does, reduce the number of repetitions.
Moving the wrist up and down
Rest your forearm on a table with your hand over the edge. Without a weight in your hand, lift your wrist up as far as you can, then lower it. Keep your forearm on the table.
8–10 repetitions in each directionTaking the thumb to the little finger
Rest your forearm on a table with your thumb in a comfortable position. Move your thumb across your palm towards the base of your little finger; help with your other hand if needed. Then return to the start.
12 repetitions, 3 sets, every dayHammer movement
Rest your forearm on a table; make a fist with your thumb pointing up and your hand over the edge of the table. Slowly lower your wrist towards the floor, then bring it back to the start. Without a weight at first; once it is easy, hold a light weight.
10–15 repetitions, 4 times a dayOpening the thumb against an elastic band
Loop a rubber band or hair band around your fingers and thumb. With your forearm on a table, move your thumb away from your index finger against the band, then slowly bring it back.
10–15 repetitions, 4 times a dayBall squeeze
Once the pain has settled, squeeze and release a soft ball or a rolled-up pair of socks in your palm. This restores grip strength.
10–15 repetitions, 4 times a dayIf you are using a splint, ask your hand therapist when and how often to do the exercises. If you are still struggling after four weeks, see a physiotherapist or a doctor.
Video
Videos for de Quervain’s
From the YouTube channels of Mayo Clinic in the USA and of Dr James O’Donovan, a doctor in the UK.
Is your thumb pain de Quervain’s?
A one-minute video that briefly introduces the condition.
Relief exercises
An exercise video presented by a doctor and a physiotherapist.
Frequently asked questions
Does de Quervain’s go away on its own?
In most people the symptoms settle over time with rest, a splint and adapting activities; surgery is rarely needed. If there is no improvement within four weeks, see a physiotherapist or a doctor.
How long is the splint worn?
A splint that covers both the wrist and the thumb is used. Hospital leaflets in the UK give periods of between 3 and 8 weeks; one recommends day-and-night use for six weeks, followed by gradually coming off it over 2–4 weeks. Your hand therapist or doctor decides the duration and the type.
Do cortisone injections work?
The injection is widely used, but the evidence is weak. The Cochrane review could find only a single small trial of 18 people: the pain went in all nine women who had the injection and in none of the nine who only wore a splint. Because the trial was small and of low quality, the result is not regarded as certain. The injection is usually considered when a splint and exercise are not enough.
When do exercises start?
First the wrist and thumb are rested. Once the pain settles, you begin with gentle stretches and movements, then move on to strengthening with a band and a light weight. If the discomfort after exercise lasts more than a few hours, reduce the number of repetitions.
When to seek help right away
See a doctor without delay if you have any of the following:
- Swelling and severe pain in the wrist after a fall or a blow
- Redness and warmth in the wrist together with a fever
- Numbness or tingling in the hand that does not go away
- Not being able to move the thumb at all
- Pain that does not improve despite four weeks of rest and a splint
Sources
- Dorset County Hospital NHS Foundation Trust. De Quervain's tenosynovitis. Hand Therapy patient leaflet. April 2025.
- Gloucestershire Hospitals NHS Foundation Trust. De Quervain's syndrome of the wrist. GHPI1134_07_24. July 2024.
- Leicestershire Partnership NHS Trust. De Quervain's. Leaflet 595. July 2021.
- Peters-Veluthamaningal C, van der Windt DAWM, Winters JC, Meyboom-de Jong B. Corticosteroid injection for de Quervain's tenosynovitis. Cochrane Database Syst Rev. 2009;(3):CD005616.
- Sherwood Forest Hospitals NHS Foundation Trust. De Quervain's tenosynovitis. Hand Therapy leaflet PIL202601-02-DQT. January 2026.
- University Hospitals Plymouth NHS Trust. DeQuervain's tenosynovitis. Patient information leaflet C-325. December 2023.