In my practice, I often see patients who complain of pain on the thumb side of the wrist, especially when holding a child, lifting a shopping bag, gripping a phone, wringing clothes, or doing repeated household and office work. A very common reason for this pattern of pain is De Quervain’s disease, also called De Quervain’s tenosynovitis. It affects the tendons near the base of the thumb and can make ordinary daily tasks surprisingly difficult.[1][2]
For many Bangladeshi patients, this problem is not just a minor pain. It can interfere with cooking, writing, typing, caring for children, riding a motorbike, using tools, and even offering prayers comfortably. The good news is that the condition is usually treatable, especially when patients seek help early and avoid ongoing strain.[1][2]
What Is De Quervain’s Disease?
De Quervain’s disease is a painful condition involving the tendons that help move the thumb. These tendons pass through a narrow tunnel on the thumb side of the wrist. When the tendon lining becomes irritated or swollen, the space becomes tight, and thumb or wrist movement starts causing pain.[1][2]
Patients sometimes describe it as:
– pain near the base of the thumb
– pain that travels slightly up the forearm
– difficulty lifting objects with one hand
– pain when twisting a jar lid, turning a key, or wringing a cloth
– a pulling or catching feeling around the wrist
Although many people call it a “wrist sprain” or “muscle pain,” the real issue is often tendon irritation rather than a fracture or joint dislocation.[1][2]
Common Symptoms to Watch For
The symptoms usually build up gradually, although some patients notice them after a sudden increase in repetitive work. Common symptoms include:
Pain on the Thumb Side of the Wrist
This is the most typical complaint. The pain is usually felt just above the wrist near the thumb base and becomes worse with gripping, pinching, lifting, or turning the wrist.[1][2]
Swelling or Tenderness
Some patients notice mild swelling or a tender area over the affected side of the wrist. Even gentle pressure may feel uncomfortable.[1][2]
Pain During Thumb Movement
Tasks such as opening containers, using scissors, lifting a baby, or scrolling on a phone with the thumb can provoke symptoms.[1][2]
Weak Grip Because of Pain
The hand may not actually be weak from nerve damage, but the pain makes the patient avoid firm gripping.[2]
Clicking or Catching Sensation
A few patients feel irritation or sticking when moving the thumb, especially if inflammation has been present for a while.[2]
Why Does It Happen?
In my practice, I usually explain to my patients that De Quervain’s disease is often linked to repetitive thumb and wrist use. It is common in people whose work or routine involves repeated gripping, twisting, lifting, or hand strain.[1][2]
Everyday Triggers in Bangladesh
In Bangladesh, practical causes may include:
– repeated hand washing or wringing clothes
– lifting babies or toddlers frequently
– heavy kitchen work
– mobile phone overuse
– sewing, tailoring, or craft work
– typing or mouse use for long hours
– salon, shop, or manual work involving repeated wrist motion
Other Risk Factors
Some patients are more likely to develop this problem if they:
– recently increased repetitive hand activity
– had a minor wrist strain
– are pregnant or caring for a newborn
– have an inflammatory condition affecting soft tissues
– delay rest and continue painful activities for weeks or months[1][3]
This does not mean every wrist pain is De Quervain’s disease. Conditions such as arthritis, thumb-base joint problems, carpal tunnel syndrome, or tendon injuries can sometimes mimic it, so proper evaluation matters.[1][2]
How I Evaluate This Problem
When I evaluate patients with this kind of pain, I pay attention to the location of pain, the activities that worsen it, and whether there is swelling or movement restriction. The diagnosis is usually made by history and physical examination rather than by expensive testing.[1][2]
Physical Examination
A simple clinical maneuver called the Finkelstein or Eichhoff test may reproduce pain on the thumb side of the wrist. This helps support the diagnosis, although the overall clinical picture is more important than any single test.[1][2]
Are X-rays or Scans Always Needed?
Not always. Imaging is usually not necessary in straightforward cases. However, I may consider an X-ray or another investigation if:
– the pain pattern is unusual
– there is a history of trauma
– arthritis or another wrist condition is suspected
– symptoms are not improving as expected[1][2]
This is important in Bangladesh because many patients either ignore symptoms too long or, on the other hand, undergo unnecessary tests before even trying proper conservative care.
Treatment Options
The main aim of treatment is to reduce tendon irritation, control pain, and allow the wrist and thumb to move comfortably again. Most patients improve without surgery if treatment begins early.[1][3]
Activity Modification
One important point I want Bangladeshi patients to understand is that treatment will not work well if the same painful movement continues all day. Temporary changes in routine are often essential.
