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The main signs and symptoms of de Quervain's tenosynovitis are pain and swelling near the base of your thumb. The pain may appear suddenly or may increase over time.

If the condition goes too long without treatment, the pain may spread farther into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

Symptoms of de Quervain's tenosynovitis include:

• Pain near the base of your thumb
• Swelling near the base of your thumb
• A fluid-filled cyst in the same region as the swelling and pain
• Difficulty moving your thumb and wrist when you're doing activities that involve grasping or pinching
• A "sticking" or "stop-and-go" sensation in your thumb when trying to move it
• A squeaking sound as the tendons try to move back and forth through the inflamed sheaths

When to see a doctor
Consult your doctor if you're still having problems with pain or function and you've already tried:

• Avoiding repetitive thumb movements whenever possible
• Avoiding pinching with your thumb when moving your wrist from side to side
• Applying cold to the affected area
• Using nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve)

If the pain continues to interfere in your daily life or activities, seek medical advice.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons run side by side from your forearm through the thumb side of your wrist. They normally glide unhampered through the small tunnel that connects them to the base of the thumb. In de Quervain's tenosynovitis, the tendons' slippery covering becomes inflamed, restricting movement of the tendons.

Chronic overuse of your wrist is commonly associated with de Quervain's tenosynovitis. For example, wringing out a cloth involves a repetitive motion, a bent wrist and the gripping of the cloth. If you repeat an action like this day after day, this combination may be enough to irritate the sheath around the two tendons.

Other causes of de Quervain's tenosynovitis include:

• Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons
• Inflammatory arthritis, such as rheumatoid arthritis

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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People most often diagnosed with de Quervain's tenosynovitis tend to be those whose occupations or hobbies involve repetitive hand and wrist motions, such as carpenters, office workers and musicians. Even the awkward hand and wrist positions that new parents use in holding and rocking their children may aggravate the condition.

Other risk factors for de Quervain's tenosynovitis include being:

• Age 30 to 50
• Female

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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You may begin to limit your hand and wrist movements to avoid pain from untreated de Quervain's tenosynovitis. Lack of movement leads to more pain and less strength and flexibility in your hand. Eventually, your range of motion may be severely restricted.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Make an appointment with your doctor if you have hand- or wrist-related pain and self-care measures — such as avoiding activities that trigger your pain — aren't helping. After an initial exam, your doctor may refer you to an orthopedist, rheumatologist, hand therapist or occupational therapist.

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• List any symptoms you've been having and for how long.
• Write down your key medical information, including other conditions with which you've been diagnosed and all medications and supplements you're taking.
• Note hobbies and activities that may strain your hand or wrist, such as knitting, gardening, playing an instrument, participating in racket sports or performing repetitive workplace activities.
• Note any recent injuries that may have damaged your hand or wrist.
• Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask a doctor who evaluates you for wrist- or hand-related symptoms. If any additional questions occur to you during your visit, don't hesitate to ask.

• What is the most likely cause of my signs and symptoms?
• Are there any other possible causes?
• Do I need any tests to confirm the diagnosis?
• What treatment approach do you recommend?
• What is the likelihood that I will need surgery?
• How long will I need to avoid the activities that caused my condition?
• What other self-care measures should I be taking?
• How often will you see me to monitor my progress?
• Should I see a specialist?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

• What are your symptoms?
• When did you first notice these symptoms?
• Have your symptoms been getting worse?
• Do any particular activities seem to trigger your symptoms?
• Do you participate in any hobbies or sports that involve repetitive hand or wrist movements?
• What tasks do you perform at work?
• Have you recently had any injuries that may have caused hand or wrist damage?
• Does it help to avoid the activities that trigger your symptoms?
• Have you tried any at-home treatments, such as over-the-counter pain relievers? Has anything helped?
• What other medications are you currently taking, including vitamins and supplements?
• Have you been diagnosed with any other medical conditions?

What you can do in the meantime
In the time leading up to your appointment, avoid activities that cause or worsen your pain. To relieve your pain, try using nonsteroidal anti-inflammatory drugs (NSAIDs) and applying ice to the affected area.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

To diagnose de Quervain's tenosynovitis, your doctor likely will confirm that you have both:

• Tenderness when pressure is applied on the thumb side of the wrist
• Positive results on a Finkelstein test

In a Finkelstein test, you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, the test is considered positive.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

To reduce pain and swelling, initial treatment of de Quervain's tenosynovitis may include:

• Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
• Avoiding repetitive thumb movements whenever possible
• Avoiding pinching with your thumb when moving your wrist from side to side
• Applying ice to the affected area
• Using NSAIDs, such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve)

Your doctor may also recommend injections of corticosteroid medications into the tendon sheath to reduce swelling.

Treatment is generally successful if begun early on, though the pain may recur if you continue the repetitive motions that aggravate your condition.

Making adjustments
Your medical care may include a visit with a physical therapist or occupational therapist, who may review your habits and give suggestions on how to make necessary adjustments to relieve stress on your wrists. Your therapist can also teach you exercises focused on your wrist, hand and arm to strengthen your muscles, reduce pain and limit the irritation of the tendons. The therapist may also make a splint to immobilize your wrist and thumb if off-the-shelf versions don't fit you well.

In more serious cases
If your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure and restore free tendon gliding.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

If you don't need surgery, caring for your condition is much the same as preventing it:

• Avoid repetitive hand and wrist movements.
• Wear a brace or splint if suggested by your doctor.
• Follow through with recommended exercises.
• Take special note of any activity that causes pain, swelling or numbness in your thumb and wrist, try to avoid it, and share that information with your doctor.

If you do need surgery, it may be several months before the tenderness in your wrist completely goes away. Your doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent a recurrence of the condition.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Since the underlying cause of de Quervain's tenosynovitis isn't known, there's no clear way to prevent the condition. Still, if you have wrist pain that's aggravated by repetitive wrist and hand movements, it may help to avoid actions such as:

• Heavy grasping
• Wringing or twisting motions
• Pinching with your thumb while moving your wrist from side to side

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.