From the Research
The treatment for de Quervain's tenosynovitis typically begins with conservative measures, including rest, ice application, and immobilization of the thumb and wrist with a splint or brace, as well as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, with corticosteroid injections and physical therapy considered if initial measures do not provide relief 1.
Key Components of Treatment
- Rest and immobilization to reduce inflammation and stress on the affected tendons
- Ice application to reduce pain and inflammation
- Use of NSAIDs such as ibuprofen (400-800mg three times daily) or naproxen (250-500mg twice daily) to manage pain and inflammation
- Corticosteroid injections into the tendon sheath for patients who do not respond to initial conservative measures, with approximately 70-80% of patients experiencing significant improvement after one or two injections 2
- Physical therapy focusing on gentle stretching and strengthening exercises for the wrist and thumb once acute pain subsides
- Occupational therapy to modify activities that aggravate the condition
Considerations for Treatment
- A multimodal approach with conservative management is the most effective treatment for de Quervain's tenosynovitis, with surgical intervention usually not necessary 1
- Local anaesthetics (neural therapy) may also be effective in reducing pain and improving hand functions in patients with de Quervain tenosynovitis 3
- For persistent cases not responding to conservative treatment after 3-6 months, surgical release of the tendon sheath (de Quervain's release) may be necessary
Evidence-Based Recommendations
- The most recent and highest quality study 3 suggests that neural therapy may be an effective addition to conservative treatment for de Quervain's tenosynovitis
- Other studies 2, 4 support the use of corticosteroid injections and physical therapy as effective treatments for de Quervain's tenosynovitis
- The use of NSAIDs and immobilization are also supported by the literature as initial conservative measures 1, 5