De Quervain’s Tenosynovitis Physiotherapy
Thumb-side wrist pain is common in anyone whose hands do the same job all day — repeated lifting, gripping and twisting. The pain is mechanical and specific to certain movements, and the plan usually has to work around hand demands you cannot simply stop.
Individual rehabilitation plan — shaped by the assessment, reviewed as you progress
We assess your situation first, explain what the assessment shows, and agree a suitable rehabilitation direction with you. WhatsApp us to book, or ask first.
Two thumb tendons run through a narrow tunnel at the thumb side of the wrist. When the tunnel and tendon sheath become irritated and thickened, movements that pull the thumb away from the hand start to hurt. It is described as more common in repetitive gripping, lifting and twisting work. Symptoms alone cannot diagnose it: thumb-base arthritis, wrist joint problems and nerve irritation can all produce pain in the same region, so an in-person examination is what separates them.
The usual pattern is sharp pain on the thumb side of the wrist when lifting a load with the thumb taking the weight, wringing a towel, turning a key, opening a jar or holding a phone, often with local tenderness and sometimes swelling. Other possible causes deserve a look: arthritis at the base of the thumb tends to hurt with pinch and pressure through the joint, and nerve-related problems produce numbness or altered sensation rather than sharp mechanical pain — a distinction that changes the plan.
- Sharp pain on the thumb side of the wrist when lifting or gripping
- Pain wringing a towel, turning a key or opening a jar
- Tenderness and sometimes swelling just above the thumb
- Pain that flares after a day of lifting, gripping or repetitive hand work
- Grip that feels less confident because using it hurts
We start by watching what you actually do: how you lift and carry, how you hold a phone, and how you use tools at work. We then examine the thumb and wrist, test the tendons under load, check the thumb base joint, and screen the nerves of the hand so numbness or altered sensation is not mistaken for a tendon problem. We also ask about sleep and general health, since both affect how quickly irritated tissue settles.
- Your symptoms: exact location, which movements provoke them, and swelling
- Daily activities and function: lifting and carrying, housework, dressing, phone use
- Work or study demands: tools, keyboard and mouse, repetition and grip force
- Sleep: whether the wrist aches at night and how broken your sleep currently is
- Load and injury history: how your hand load changed, previous wrist injury or episodes
- Movement: thumb and wrist range of motion, and forearm rotation
- Strength and control: grip and pinch strength, and forearm and shoulder-blade support
- Neurological and general screening: sensation in the thumb and fingers, muscle power, medical history, pregnancy and medicines
The first priority is usually reducing the provocation: changing how you lift and carry, adjusting phone and tool grip, and often a period in a thumb and wrist splint. As symptoms settle, graded strengthening for the thumb, wrist and forearm rebuilds tolerance. Depending on the assessment, hands-on treatment or acupuncture may be considered where you consent; a steroid injection is a medical option some people discuss with their doctor. We do not follow a fixed routine, your preferences count, and the plan changes with your response.
Because the lifting usually cannot stop, we work on how rather than whether: supporting the load from underneath with flat hands, keeping the thumb closer to the palm, alternating sides, and using forearms for the heavier moments. Small equipment changes help too. You will get a flare-up plan for a heavy day, and at each visit we review pain with specific tasks, grip comfort, swelling and your activity and load tolerance before progressing anything.
Thumb-side wrist pain is usually well suited to a physiotherapy assessment and a load-based plan. Arrange a prompt medical review if the wrist becomes red, hot and swollen with a fever, if pain followed a fall onto the hand and did not settle within a few days, if you are pregnant and have widespread joint pain or swelling, or if symptoms are not improving despite splinting and load changes. Go to an emergency department the same day if the hand becomes cold, pale or blue, if numbness is spreading rapidly, or if the wrist looks deformed after an injury.