If you’re experiencing sharp pain on the thumb side of your wrist—especially when gripping, pinching, or turning your wrist—you may have De Quervain’s tendonitis. Sometimes called "mommy thumb" or "gamer’s thumb," this condition involves inflammation of the tendons that control thumb movement where they pass through a tight tunnel at the wrist.
What Is De Quervain’s Tendonitis?
De Quervain’s tenosynovitis is inflammation and swelling of the first dorsal compartment of the wrist. This compartment contains two tendons—the abductor pollicis longus (APL) and extensor pollicis brevis (EPB)—that help move your thumb away from your hand and extend it. When the compartment becomes swollen or thickened, the tendons can’t glide smoothly, causing pain with thumb and wrist motion.
What Causes De Quervain’s?
- Repetitive thumb and wrist motions (texting, gaming, lifting a baby, gardening, golf)
- New mothers are particularly susceptible—the combination of hormonal changes and repetitive baby lifting makes this extremely common postpartum
- Inflammatory conditions like rheumatoid arthritis
- Direct trauma to the wrist
- Women are affected more often than men
In Phoenix’s active population—golfers in Scottsdale, new parents in Chandler, and workers across the Valley—De Quervain’s is one of the most common conditions I see.
Symptoms of De Quervain’s Tendonitis
- Pain on the thumb side of the wrist, sometimes radiating into the thumb or up the forearm
- Swelling at the base of the thumb near the wrist
- Pain worsened by gripping, pinching, wringing, or twisting motions
- A catching or snapping sensation with thumb movement
- Difficulty with activities like opening jars, turning doorknobs, or lifting a child
Diagnosis
Diagnosis is primarily clinical. The Finkelstein test is the hallmark: I’ll have you tuck your thumb into your fist and tilt your hand toward the pinky side. If this reproduces sharp pain at the wrist, the test is positive and the diagnosis is essentially confirmed. No imaging is usually necessary, though ultrasound can be helpful in some cases.
Non-Surgical Treatment
SPLINTING
A thumb spica splint immobilizes the thumb and wrist, reducing tendon irritation. I recommend wearing it as much as possible, especially during aggravating activities.
ANTI-INFLAMMATORY MEDICATIONS
NSAIDs like ibuprofen or naproxen can help reduce pain and inflammation, though they rarely resolve the condition on their own.
CORTICOSTEROID INJECTION
Injection of corticosteroid into the first dorsal compartment is the most effective non-surgical treatment. Studies show resolution rates of approximately 70–80% with a single injection. This is my go-to first-line treatment for most patients. A second injection can be considered if the first provides partial or temporary relief.
When Is Surgery Needed?
I recommend De Quervain’s release surgery when symptoms persist despite one or two corticosteroid injections. The procedure involves opening the first dorsal compartment to give the tendons more room. I carefully inspect for a septum (a partition that divides the compartment into subcompartments)—present in up to 30% of patients—and release it, which is a common cause of failed non-surgical treatment.
The procedure takes about 10–15 minutes under local anesthesia. Sutures come out in 10–14 days, and most patients return to full activity within 4–6 weeks.
Thumb and Wrist Pain Relief in Phoenix
Don’t let thumb pain sideline you from the activities you enjoy. Whether you’re in Scottsdale, Mesa, Chandler, Gilbert, or anywhere in the Phoenix metro, I can help you get back to pain-free function—usually with a simple office injection. Call (602) 258-4788 or visit toddrichardsmd.com to book an appointment with Dr. Todd Richards. Most insurance plans accepted. Same-week appointments often available.