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Physical Medicine and Rehabilitation for De Quervain Tenosynovitis Follow-up

  • Author: Patrick M Foye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
Updated: Apr 27, 2016

Further Outpatient Care

Have the patient return for reevaluation approximately 2-4 weeks after corticosteroid injection.

At the time of the follow-up visit, assess for therapeutic response to the injection and evaluate for any complication or further treatment needs.

Instruct the patient to contact his/her physician sooner if a significant progression of symptoms is noted or if local signs of infection are present at the injection site.


Inpatient & Outpatient Medications

Please see Medication.



A patient with de Quervain tenosynovitis may need to avoid certain repetitive activities of the wrist or thumb until adequate rehabilitation has been achieved.



Please see Other Treatment, which includes a discussion of potential complications of corticosteroid injections.



Most patients with de Quervain tenosynovitis respond very well to nonsurgical treatment (eg, corticosteroid injection, splinting, physical therapy, occupational therapy).

For severe cases that are unresponsive to injections, refer the patient for surgical treatment to decompress the first dorsal compartment.

A literature review by Cavaleri et al indicated that the combined use of orthoses and corticosteroid injections for de Quervain tenosynovitis is more effective at improving pain and function than the use of either treatment by itself.[32]


Patient Education

As with any injection, educate the patient to watch for signs or symptoms of local infection at the injection site.

Instruct diabetic patients that they may experience a transient increase in blood glucose levels with corticosteroid injection.

Educate patients that symptomatic improvement from corticosteroid injection usually is observed a few days after injection. Patients should understand that they may experience a mild, transient increase in symptoms during the period in which the local anesthetic has worn off but the steroids have not yet begun to demonstrate a noticeable therapeutic effect.

For patient education resources, see the Hand, Wrist, Elbow, and Shoulder Center and Sprains and Strains - First Aid and Emergency Center, as well as Repetitive Motion Injuries and Sprains and Strains.

Contributor Information and Disclosures

Patrick M Foye, MD Director of Coccyx Pain Center, Professor and Interim Chair of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, International Spine Intervention Society, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists

Disclosure: Nothing to disclose.


Todd P Stitik, MD Professor, Department of Physical Medicine and Rehabilitation, Director, Outpatient Occupational/Musculoskeletal Medicine, Rutgers New Jersey Medical School

Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Physiatric Association of Spine, Sports and Occupational Rehabilitation, Phi Beta Kappa

Disclosure: Nothing to disclose.

Varun Patibanda, MD Research Associate, Rutgers New Jersey Medical School

Varun Patibanda, MD is a member of the following medical societies: American Medical Association, New Jersey Society of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard Salcido, MD Chairman, Erdman Professor of Rehabilitation, Department of Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine

Richard Salcido, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Association for Physician Leadership, American Medical Association, Academy of Spinal Cord Injury Professionals

Disclosure: Nothing to disclose.

Chief Editor

Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans

Stephen Kishner, MD, MHA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Robert L Sheridan, MD Assistant Chief of Staff, Chief of Burn Surgery, Shriners Burns Hospital; Associate Professor of Surgery, Department of Surgery, Division of Trauma and Burns, Massachusetts General Hospital and Harvard Medical School

Robert L Sheridan, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, American College of Surgeons

Disclosure: Received research grant from: Shriners Hospitals for Children; Physical Sciences Inc<br/>Received income in an amount equal to or greater than $250 from: SimQuest Inc -- consultant on burn mapping softwear ($1,500).


Debra Ibrahim New York College of Osteopathic Medicine

Disclosure: Nothing to disclose.

Evish Kamrava St George's University School of Medicine

Disclosure: Nothing to disclose.

Cyrus Kao St George's University School of Medicine

Disclosure: Nothing to disclose.

Jason Lee St George's University School of Medicine

Disclosure: Nothing to disclose.

Dev Sinha, MD American University of Antigua School of Medicine and Health Sciences

Disclosure: Nothing to disclose.

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The first dorsal compartment of the wrist includes the tendon sheath that encloses the abductor pollicis longus and the extensor pollicis brevis tendons at the lateral border of the anatomic snuffbox.
The Finkelstein test is performed by having the patient make a fist with the thumb inside the fingers. The clinician then applies ulnar deviation of the wrist to reproduce the presenting symptoms of dorsolateral wrist pain.
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