Orthopedics Hand & Wrist Wrist Conditions 11 Exercises to Reduce de Quervain's Tenosynovitis By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS LinkedIn Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. Learn about our editorial process Published on February 17, 2022 Medically reviewed by Laura Campedelli, PT, DPT Medically reviewed by Laura Campedelli, PT, DPT LinkedIn Laura Campedelli, PT, DPT, is a physical therapist with experience in hospital-based acute care and outpatient therapy with both children and adults. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Why Exercise Helps Getting Started Exercises When to See a Healthcare Provider De Quervain’s tenosynovitis is a painful condition that occurs when two of the thumb’s tendons—located on the thumb side of your wrist—become overused or irritated. These tendons are covered by a slick coating called synovium that allows them to smoothly slide back and forth through the sheaths that enclose them. Occasionally, overuse of the hand or wrist causes swelling and inflammation in these tendons or in the sheaths themselves. This can lead to a number of symptoms, including: Pinpoint pain on the thumb side of the wristSwelling or puffiness near the base of the thumbNumbness or tingling on the back of the thumb or second fingerCatching or snapping sensations while moving the thumbSubtle squeaking sounds during thumb movement This article will outline several exercises that—along with other interventions—may help to alleviate the symptoms of de Quervain's tenosynovitis. ljubaphoto / Getty Images How Exercises Help With de Quervain’s Tenosynovitis Exercise is one part of a multifaceted approach to treating de Quervain’s tenosynovitis. It is commonly used along with other treatments like: Anti-inflammatory medication Pain-relieving cortisone injections Splinting Activity modification Typically, occupational or physical therapy is also started early on in the process. During rehab, your therapist will teach you specific techniques designed to increase mobility in the affected thumb tendons (the abductor pollicis longus and the extensor pollicis brevis). Initially, pain-free thumb and wrist range of motion exercises are performed to improve tendon gliding within the sheaths. Later, strengthening exercises may also be added to help you return to your prior activities. What You’ll Need to Get Started Fortunately, most exercises for de Quervain’s tenosynovitis do not require much equipment. Techniques usually are performed using only a tabletop, light hand weights, resistance band, squeezable ball, or piece of putty. Safety Tips and Precautions Before starting any new exercise, be sure to speak to your healthcare provider about whether it is appropriate for you. Also, do not continue with any exercise that causes your symptoms to worsen. Exercises Some of the most common exercises for this diagnosis are: Opposition Stretch Sit with your palm facing upward and resting on a table. Slowly move your thumb across your hand and try to touch your pinkie finger. When they contact one another, hold the position for six seconds before relaxing. Repeat this 10 times per day. Wrist Extension Stretch With your elbow straight and your palm down, extend your arm out in front of your body. Use your other hand to pull the palm of the affected hand upward until a stretch is felt. Hold this pull for 15–30 seconds before releasing the hand. Complete two or three repetitions daily. Wrist Flexion Stretch Assume the same arm position as the wrist extension stretch, only this time push the top of the affected hand downward. When a stretch is felt, maintain the position for 15–30 seconds. Again, try to do this two or three times each day. Wrist Radial Deviation Strengthening Hold a light weight and allow your hand to hang off the edge of a table with your thumb pointing up. Without lifting your forearm off the surface, slowly move your wrist up and down in a pain-free range. Do two sets of 15 repetitions per day. Wrist Extension Strengthening Hold one end of a resistance band and allow your hand to hang palm down off the edge of a table. With the other end of the band secured, move your wrist upward as the tension in the band increases. At the top of the comfortable range, rest for a second before slowly returning to the starting position. Try three sets of 15 repetitions daily. Wrist Flexion Strengthening Holding a secured resistance band, assume the same position as the wrist extension strengthening exercise only with your palm facing upward. Slowly raise your hand toward the ceiling without causing pain and then return to the initial position. Repeat the exercise 15 times and try to complete two sets each day. Grip Strengthening Holding a squishy ball or a piece of putty, squeeze tightly as you make a fist and hold it for five seconds. Relax your hand before repeating the exercise. Try two sets of 15 repetitions every day. Finger Spring Secure a large rubber band around your thumb and fingers. With your palm resting facedown on a table, spread your fingers as wide as you can as you stretch the band. Hold this position for one or two seconds before relaxing. Try this 15 times in a row and do two sets daily. Thumb Lifts Rest the outside of your hand on a table and lift your thumb away from it in an arc-like motion (like you are giving a thumbs-up sign) until you feel a pull. Hold this stretch for six seconds. Repeat the technique eight to 12 times. Thumb Flexion Assume the same position as you did for the thumb lift exercise. This time, use your other hand to gently push the thumb down toward the palm of your hand. When a stretch is felt, hold it for 15–30 seconds. Try to complete two to four repetitions every day. Finkelstein Stretch Make a fist around your affected thumb and extend your arm in front of you. With your palm pointed inward, use your other hand to push down on your fist until you feel a pull on the thumb side of your wrist. Hold the stretch for 15–30 seconds. Do two to four stretches every day. When to See a Healthcare Provider Modifying your activities to avoid repetitive or potentially irritating movements is a key component when treating de Quervain’s tenosynovitis. This action—along with icing the area and taking over-the-counter (OTC) NSAIDs (nonsteroidal anti-inflammatory drugs, such as Advil or Motrin ibuprofen or Aleve naproxen)—should help reduce your initial symptoms. If these initial conservative strategies fail to improve your condition or if your symptoms are worsening overall, it is important to speak to a healthcare provider. Following a detailed evaluation, your physician can provide a concrete diagnosis and outline the many treatment options available to you. Summary De Quervain’s tenosynovitis occurs when the tendons that lie just below the base of the thumb on the wrist become irritated and inflamed. This issue can lead to localized swelling, tenderness, numbness, or tingling. Exercises may help these tendons become more mobile and may also strengthen the supporting muscles in the hand or wrist. Along with splinting, activity modification, and pain medications or injections, exercise can play an important role in treating this condition. A Word From Verywell De Quervain’s tenosynovitis may seem like a minor issue, but this condition can have a profound impact. Swelling and inflammation in the thumb’s tendons can cause pain with even the most minor wrist movements and can significantly alter your daily function. Fortunately, many helpful treatments are available. If you are dealing with the symptoms associated with this diagnosis, be sure to speak to a healthcare provider about your condition. Taking this step can start you on the road to recovery from this stubborn issue. Frequently Asked Questions Is de Quervain’s tenosynovitis curable? The symptoms associated with de Quervain’s tenosynovitis are usually curable. In most instances, the combination of activity modification, anti-inflammatory medications or injections, splinting, and exercises are effective in treating this condition. How long does it take to heal from de Quervain’s tenosynovitis? De Quervain’s tenosynovitis can be a stubborn diagnosis. Most people see a dramatic improvement in their symptoms after four to six weeks of treatment. After this time, the swelling in the area typically subsides and your overall hand function improves. What makes de Quervain’s tenosynovitis get worse? Repetitive or forceful hand and wrist activities tend to worsen the symptoms associated with de Quervain’s tenosynovitis. Grasping or twisting tasks can be particularly irritating. Repetitive wringing or squeezing can also cause aggravation. What happens if you don’t treat de Quervain’s tenosynovitis? De Quervain’s tenosynovitis generally responds well to treatment. That said, if left untreated, the condition can cause a significant and permanent range-of-motion limitations. It can also ultimately lead to the rupture of the tendon sheath, which significantly alters your hand and wrist function. 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Family Physicians. De Quervain’s tenosynovitis. Goel R, Abzug JM. De quervain’s tenosynovitis:a review of the rehabilitative options. Hand(New York, N,Y). 2015;10(1):1-5. doi:10.1007/s11552-014-9649-3 Tufts Medical Center Community Care. De Quervain’s tenosynovitis exercises. Kaiser Permanente. Wrist/handpain: de Quervain’s syndrome. By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. 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