Private de quervain's tenosynovitis clinic in London, same-day physiotherapy.

Recognising it

• Pain and tenderness over the bony prominence on the thumb side of the wrist.
• Worse gripping, wringing, lifting, opening jars, or turning a key.
• Sometimes a thickened area or creaking over the tendons.
• A simple self-test: tuck the thumb into the palm, close the fingers over it, and bend the wrist towards the little finger. Sharp pain over the thumb side strongly suggests De Quervain's.

Treatment

• A thumb spica splint immobilising the wrist and the base of the thumb, leaving the tip free. Worn consistently, including at night, for four to six weeks.
• Activity modification — identify and change the movement that provokes it. Without this, everything else is temporary.
• Anti-inflammatory gel locally, and oral anti-inflammatories if suitable.
• Corticosteroid injection into the tendon sheath is highly effective here — unlike in many other tendon problems — and settles a majority of cases, sometimes with a single injection. It may be repeated once.
• Hand therapy with graded tendon gliding and strengthening once pain allows.
• Surgical release of the tendon sheath, a small day-case procedure, for cases not responding to splinting and injection.

While it settles

• Lift with two hands and forearms rather than pinching with thumbs.
• Avoid repetitive wringing, twisting and lifting with the wrist bent sideways.
• Take breaks from phone use held in one hand — thumb scrolling is a common aggravator.
• Expect improvement over weeks rather than days, and keep the splint on even on good days.