As specialists in Physical Medicine and Rehabilitation, we frequently encounter De Quervain’s tendinitis among the musculoskeletal conditions we treat. This condition, which manifests around the wrist and base of the thumb, can significantly disrupt your daily activities. Mothers, individuals involved in handcrafts, and desk workers are particularly affected. In this article, you’ll learn about the causes, symptoms, diagnosis, and modern physiotherapy treatments used to manage De Quervain’s tendinitis.
What is De Quervain’s Tendinitis?
De Quervain’s tendinitis occurs when two important tendons that help lift and extend the thumb (abductor pollicis longus and extensor pollicis brevis) become inflamed within their tendon sheath. Due to narrowing of this sheath, the tendons rub against it during movement, leading to thickening, tenderness, and pain over time.
Common Symptoms
You may experience:
- Pain on the outer side of the wrist and base of the thumb
- Difficulty with gripping, twisting, and pinching motions
- Swelling, stiffness, and tenderness to touch
- Worsening pain during repetitive or forceful wrist movements
Diagnosis Process
Diagnosis is primarily clinical. The Finkelstein test is particularly useful in confirming De Quervain’s tendinitis. If needed, imaging techniques such as ultrasound may be used to assess the condition of the tendons.
Our Physiotherapy Approach
In treating De Quervain’s tendinitis, we adopt a stepwise and multidisciplinary approach. Our main goals are to reduce your pain, restore function, and prevent recurrence. We combine traditional and advanced physiotherapy techniques in our treatment protocol:
1. Immobilization and Medication: We use custom wrist and thumb splints to restrict movement and allow inflammation to subside.Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to help reduce pain and swelling.
2. Physical Therapy Modalities: To relieve pain and accelerate healing, we implement several clinically proven methods:
- Ultrasound Therapy: Penetrates deep tissues to reduce inflammation
- TENS (Transcutaneous Electrical Nerve Stimulation): Helps block pain signals
- Manual Therapy: Relaxes soft tissues around the tendons and improves circulation
- Exercise Program: Focuses on stretching and strengthening to prevent functional loss
3. ESWT (Extracorporeal Shock Wave Therapy): One of the most effective recent treatments for chronic and recurring cases of De Quervain’s is ESWT. By delivering high-frequency sound waves to the affected tissues, we create controlled microtrauma that stimulates the body's natural healing processes. This non-invasive option can often eliminate the need for surgery.
4. BTL Magnetic Field Therapy: BTL Magnetotherapy uses low-frequency magnetic fields to support tissue repair. It accelerates cellular metabolism, reduces edema, and modulates the inflammatory response. It also enhances tendon nutrition and regeneration.
5. HILT (High-Intensity Laser Therapy): Compared to conventional low-level lasers, HILT penetrates much deeper. It uses concentrated light energy to reduce inflammation, improve blood flow, and trigger cellular repair. Many patients report a significant reduction in pain and improved range of motion after just a few sessions.
6. Corticosteroid Injections: In severe or resistant cases, we may consider local steroid injections. However, we use them cautiously and in limited numbers due to the risk of tendon weakening or rupture.
7. Surgical Intervention and Rehabilitation: For advanced cases unresponsive to conservative treatment, surgery may be required. Post-surgical rehabilitation is essential for restoring function. We closely coordinate with your surgeon to ensure an optimal recovery through tailored physiotherapy.
Tips to Prevent Recurrence
- Avoid repetitive or forceful wrist movements
- Use ergonomic tools and supports
- Perform regular stretching exercises
- Take frequent breaks during repetitive tasks
Conclusion
If left untreated, De Quervain’s tendinitis can become a chronic and disabling condition. However, with early diagnosis and a comprehensive, evidence-based physiotherapy approach, you can regain a pain-free and functional lifestyle. Advanced treatments such as ESWT, BTL magnetic field therapy, and HILT make the recovery process faster and more effective. By taking the right steps early, you can overcome this condition without needing surgery.
Dr. Lecturer Elif Berber
Physical Medicine and Rehabilitation Specialist
