De Quervain's Tenosynovitis Treatment in Faridabad
De Quervain's tenosynovitis is inflammation of the tendons on the thumb side of the wrist -- specifically the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons and their shared tendon sheath. It causes pain, swelling, and difficulty gripping at the base of the thumb and radial (thumb) side of the wrist.
This condition is particularly common among new mothers (due to repetitive baby-lifting positions), smartphone users, and workers performing pinching and gripping tasks. At Realign Rehab Clinic in Faridabad, we provide effective physiotherapy treatment that eliminates pain and restores full hand function.
Causes of De Quervain's Tenosynovitis
- New mothers and mothers carrying infants: Repeatedly lifting a baby with the wrist cocked and thumb extended places extreme load on the APL and EPB tendons -- so common in new mothers that it is sometimes called 'mother's wrist' or 'mommy's thumb'
- Repetitive pinching and gripping tasks in occupational settings
- Smartphone and tablet use -- texting and scrolling with the thumb
- Racquet sports and cricket
- Sewing, knitting, and embroidery work
- Pregnancy and hormonal changes (oestrogen causes tendon sheath swelling)
Symptoms
- Pain and tenderness on the thumb side of the wrist
- Swelling near the base of the thumb
- Difficulty gripping, pinching, and turning the wrist
- Pain worsening when lifting objects, opening jars, or making a fist
- A squeaking or creaking sensation (crepitus) when moving the thumb
- Positive Finkelstein test -- pain reproduced by tucking the thumb inside a fist and tilting the wrist downward
Physiotherapy Treatment Programme
1. Activity Modification and Splinting
A thumb spica splint immobilises the thumb and wrist, protecting the inflamed tendons and allowing the tendon sheath to calm down. We typically recommend splinting for 3-6 weeks during the acute phase, particularly during provocative activities. For new mothers, we teach safe lifting techniques that offload the tendons while still caring for their baby.
2. Manual Therapy
- Soft tissue mobilisation of the APL and EPB tendons
- Radiocarpal and first CMC (carpometacarpal) joint mobilisation
- Gentle friction massage to reduce tendon sheath adhesions
3. Electrotherapy
- Therapeutic ultrasound to reduce tendon sheath inflammation
- Iontophoresis (medication delivery via electrical current) for stubborn cases
- TENS for pain management
4. Progressive Loading Exercises
Once acute inflammation is controlled, a progressive tendon loading programme rebuilds tendon strength and load tolerance, preventing recurrence. Exercises focus on eccentric thumb extension and grip strengthening.
5. Ergonomic and Technique Modifications
For smartphone users: voice input, stylus use, and adjusting phone-holding positions reduce tendon stress. For new mothers: two-handed scooping lifts instead of single-hand grips with extended thumbs significantly reduce recurrence risk.
De Quervain's in New Mothers: Special Considerations
New mothers often notice symptoms worsening in the first weeks after delivery as they begin frequent baby lifting. Our Faridabad physiotherapy team provides specialised guidance for postpartum women, addressing both the tenosynovitis and the breastfeeding and baby-care positions that aggravate it. Treatment is safe during breastfeeding.
Recovery Timeline
With consistent physiotherapy and splinting compliance, most patients achieve significant improvement within 6-8 weeks. Complete resolution typically occurs within 3-4 months. Cortisone injections may be considered if physiotherapy alone is insufficient, but we recommend a full physiotherapy trial first.
Frequently Asked Questions
Q: Can De Quervain's tenosynovitis heal on its own?
Mild cases may improve with rest alone, but most cases require physiotherapy to fully resolve and prevent recurrence. Ignoring it leads to chronic tendon changes that take much longer to treat.
Q: Is De Quervain's common in new mothers?
Yes -- it is extremely common in the postpartum period due to repeated baby lifting. Up to 50% of new mothers experience some degree of wrist-thumb pain, and De Quervain's is a leading cause. It is completely treatable with physiotherapy.
Q: Can I continue breastfeeding while being treated?
Absolutely. Physiotherapy treatment including splinting and exercises is completely safe during breastfeeding. We will also advise on optimal breastfeeding positions to reduce wrist stress.