De Quervain’s Tenosynovitis: Thumb Wrist Pain (Finkelstein Test, Causes, Treatment)

De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist, particularly the abductor pollicis longus and extensor pollicis brevis, as they pass through the first dorsal compartment. It commonly develops from repetitive thumb and wrist movements and is often seen in caregivers and new parents due to frequent lifting and holding. Symptoms usually include pain and tenderness along the radial side of the wrist, swelling, and discomfort with gripping, pinching, or twisting motions. A key clinical sign is a positive Finkelstein test, which reproduces sharp pain when the thumb is tucked into the palm and the wrist is bent toward the ulna. Diagnosis is mainly clinical, though ultrasound or MRI may help in unclear cases or when ruling out other conditions. Treatment typically involves activity modification, thumb splinting, pain relief, physiotherapy, and corticosteroid injection, while surgery may be considered for persistent cases. Early recognition and treatment usually lead to an excellent recovery.