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Common wrist injury Quervains Tenosynovitis

Quervain’s Tenosynovitis

The condition called de quervains tenosynovitis causes pain on the inside of the wrist and forearm just above the thump.

  • It is the inflammation of the fluid filled sheath that surrounds a tendon
  • This is the common problem effecting the wrist and usually easy to diagnose
  • Tendons connect muscle to the born and the muscles pull on tendons for movements.
  • The muscles connected to anterior posterior ligaments and extensor pollicis brevis tendons are on the back of the forearm.
  • APL & EPB (Refer above for the abbrev) tendons travel inside edge of the wrist.
  • They pass through a tunnel near the end of the forearm.
  • This tunnel is lined with a slippery coating called tenosynovium
  • The inflammation of the tenosynovium and tendon is called tenosynovitis
  • In this condition the inflammation constricts the movement of the tendons within the tunnel.


  • Repeated thump motions such as  grasping, pinching, squeezing
  • Arthritis or injury
  • Introduction of bacteria into a sheath through a small penetrating wound such as that made by the point of needle or thorn.


  • Soreness of thumb , side of the forearm and near the wrist.
  • The two tendons may move through the constricted tunnel. These causes noise while moving hand called crepitus.
  • Pain and swelling
  • Difficulty in moving joint.


Flnklestein test

  • Bend your thumb into your palm
  • Grasp the thumb with in your fingers making a fist.
  • Bend your wrist away from your thumb
  • If you feel pain over the tendons to the thumb the test is positive.

Physical examination shows swelling

Stretching tendon to check whether there is pain.


  1. Stop all activities that causes your symptoms
  2. Take break when doing repeated hand and thumb movements
  3. Avoid grasping , wringing or turning and twisting movements of the wrist.
  4. After injury is evaluated wear a special forearm and thumb splint called a thumb – spica spint.
  5. Use Anti inflammation drugs
  6. Stretching and strengthening exercise to wrist and forearm.

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