Hand & Wrist

De Quervain's Tenosynovitis

De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. Named after the Swiss surgeon Fritz de Quervain who first described it in 1895, the condition causes significant pain with thumb and wrist movement — particularly with gripping, pinching, and lifting. New parents, caregivers, and individuals performing repetitive wrist and thumb motions are disproportionately affected. At Maryland Orthopedic Specialists, our hand surgeons offer accurate diagnosis and a full range of treatments, from targeted corticosteroid injections to outpatient surgical release.

Ready to get started?

Schedule an appointment with a specialist experienced in treating de quervain's tenosynovitis.

Schedule Now

or call (301) 515-0900

In-network with most major insurance plans. Same-day appointments available for acute injuries.

What is de quervain's tenosynovitis?

The first dorsal compartment of the wrist contains two tendons that control thumb movement: - Abductor pollicis longus (APL): Abducts the thumb outward away from the palm. - Extensor pollicis brevis (EPB): Extends the thumb at the MCP joint. These two tendons travel through a tight fibro-osseous tunnel (the first extensor compartment retinaculum) at the level of the radial styloid.

The first dorsal compartment of the wrist contains two tendons that control thumb movement:

Abductor pollicis longus (APL): Abducts the thumb outward away from the palm.
Extensor pollicis brevis (EPB): Extends the thumb at the MCP joint.

These two tendons travel through a tight fibro-osseous tunnel (the first extensor compartment retinaculum) at the level of the radial styloid. In De Quervain's tenosynovitis, the retinacular sheath surrounding these tendons becomes thickened and inflamed — a process analogous to trigger finger but in a different location and involving different tendons. The narrowed compartment creates friction and pain whenever the tendons move through it.

The Accessory EPB Compartment

An important anatomical variant is the presence of a separate subcompartment for the EPB tendon within the first dorsal compartment, present in approximately 30–40% of patients. This is clinically significant: if a surgeon releases only the APL sub-compartment without identifying and releasing the separate EPB compartment, symptoms can persist or recur. Careful intraoperative identification of both tendons and their respective sub-compartments is essential for a complete release.

Who Is Affected?

De Quervain's is approximately 8–10 times more common in women than men. Risk groups include:

New mothers and primary caregivers: Repetitive lifting of an infant with the wrist in ulnar deviation and the thumb extended loads the first dorsal compartment repeatedly. "New mother's wrist" is a well-recognized clinical entity. Hormonal changes during and after pregnancy may also predispose the tendon sheath to inflammation.
Individuals performing repetitive radial-ulnar wrist deviation with the thumb extended: Assembly workers, pianists, golfers, bowlers.
Middle-aged adults (30–50 years).
Patients with rheumatoid arthritis or inflammatory arthritis.

Treatment options

Non-Operative

A thumb spica splint rests the irritated tendons, and avoiding repetitive wrist and thumb movements gives them time to heal. A corticosteroid injection directly into the tendon sheath is the most effective non-surgical treatment, relieving pain in the majority of patients. Two injections may be needed for lasting relief.

Surgical Procedure

De Quervain's Release

Surgical release of the first dorsal compartment to relieve pinching of the abductor pollicis longus and extensor pollicis brevis tendons. Addresses the anatomic variation of septated compartments to minimize recurrence.

Click for more

Frequently Asked Questions

I've had this since having my baby — will it go away on its own?

De Quervain's in new mothers often improves as infant-lifting demands evolve (babies develop head control), but persistent or severe cases benefit from splinting and injection rather than waiting. Most patients recover without surgery.

Is the injection painful?

An injection into the first dorsal compartment can be uncomfortable, but topical or local anesthesia before the injection minimizes discomfort. Most patients report pressure rather than sharp pain.

Will the surgery leave a visible scar?

A small scar (1–2 cm) will remain over the radial styloid. In most patients this fades to an inconspicuous white line. Scar sensitivity typically resolves by 3 months.

Can De Quervain's recur after surgery?

Recurrence after a complete release is very uncommon. The most common reason for persistent symptoms after surgery is failure to release a separate EPB sub-compartment, which our surgeons routinely check for.

How long does it take to recover from De Quervain's release surgery, and when can I return to work?

De Quervain's release is a short outpatient procedure, and most patients experience significant pain relief within days of surgery. Desk or light office work is typically possible within one to two weeks, while jobs involving heavy gripping or lifting may require four to six weeks of recovery. Formal hand therapy is usually recommended to regain strength and prevent scar tenderness. At MOS, your surgeon will advise you on activity restrictions based on your specific job demands and track your progress to ensure full function is restored.

Meet the specialists

Peter G. Fitzgibbons, MD

Hand Surgery · Orthopedic Surgery

Meet Dr. Fitzgibbons →

Related conditions

Hand & Wrist Tendonitis Trigger Finger Carpal Tunnel Syndrome Hand & Wrist Arthritis

Medically reviewed by Peter G. Fitzgibbons, MD, MD

Last reviewed June 16, 2026