From the Research
De Quervain's tenosynovitis should be treated with a multimodal approach, starting with conservative management, including rest, immobilization, and non-steroidal anti-inflammatory drugs (NSAIDs), and considering corticosteroid injections for patients who do not respond to initial treatment. The treatment for De Quervain's tenosynovitis typically begins with conservative measures aimed at reducing inflammation and pain. Initial treatment includes rest, immobilization with a thumb spica splint worn 24 hours a day for 4-6 weeks, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) 1. Ice application for 15-20 minutes several times daily can help reduce inflammation. Activity modification to avoid thumb and wrist movements that aggravate symptoms, particularly forceful grasping and repetitive thumb movements, is essential.
- Conservative management is the most effective approach, especially in the acute phase 1
- Corticosteroid injections into the tendon sheath can be highly effective for patients who do not respond to initial treatment, with approximately 70-80% of patients experiencing significant improvement after one or two injections 2, 3
- Physical therapy focusing on gentle stretching and strengthening exercises may be recommended as symptoms improve
- For cases resistant to conservative treatment after 6 months, surgical release of the first dorsal compartment may be necessary 4 The most recent and highest quality study, published in 2021, found that neural therapy (NT) seems to be effective in reducing pain and improving hand functions in patients with De Quervain tenosynovitis 5. However, the primary approach remains conservative management, with corticosteroid injections considered for non-responsive cases.