Conditions we diagnose and treat

De Quervain's Tenosynovitis Treatment in London

Available at LSRI Harley Street (W1G 9QJ) and LSRI Northwest London, Harrow (HA2 7SJ).

De Quervain's tenosynovitis is a painful condition affecting two tendons on the thumb side of the wrist.

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GMC / FRCR Dr Prashant Sankaye, Consultant MSK Radiologist

These tendons run through a narrow tunnel (tendon sheath), and when the sheath thickens and becomes inflamed, moving the thumb and wrist becomes painful. It is more common in women, particularly during pregnancy and in the months after having a baby, when lifting and feeding put repeated strain on the thumb. It also affects people whose work, sport or hobbies involve repetitive gripping, pinching or wrist movement. At LSRI, Dr Prashant Sankaye, Consultant MSK Radiologist, uses ultrasound to confirm the diagnosis and, where it is the right option for you, offers precise ultrasound-guided injections into the tendon sheath.

Why choose LSRI

Consultant-led care from Dr Prashant Sankaye, Consultant MSK Radiologist with more than 20 years’ experience.
Diagnosis and ultrasound-guided treatment from the same specialist.
Two clinics: LSRI Harley Street (W1G 9QJ) and LSRI Northwest London in Harrow (HA2 7SJ).
No GP referral needed, and all major insurers accepted.
After Dr Sankaye has reported your scan, you can have a free 5-minute video consultation to go through the results.

Last medically reviewed by Dr Prashant Sankaye, Consultant MSK Radiologist, on 2 October 2026.

Symptoms of De Quervain's tenosynovitis

Pain and tenderness on the thumb side of the wrist, sometimes spreading up the forearm.
Pain when gripping, pinching, lifting a baby, turning a key or opening jars.
Swelling over the thumb side of the wrist.
A creaking or catching feeling when you move the thumb.
Weakness of grip because of pain.

If the wrist becomes hot, red and very swollen, or you feel unwell with a fever, seek urgent medical advice, as this can be a sign of infection.

How we diagnose De Quervain's tenosynovitis

Diagnosis starts with your history and a hand and wrist examination. Dr Sankaye will check where you are tender and use simple movement tests, such as tucking the thumb into the palm and bending the wrist, to see whether this reproduces your pain.

Ultrasound shows the thickened tendon sheath, fluid around the tendons and any swelling of the tendons themselves. It can also show whether there is a thin wall dividing the tunnel into two parts, which can matter when planning an injection. Ultrasound helps rule out other causes of pain in this area, such as a ganglion or irritation of a nearby nerve.

Arthritis at the base of the thumb can cause similar pain, so an X-ray may be arranged if this is suspected. An MRI is rarely needed but can help if the picture is unclear.

What to expect at your appointment

Dr Sankaye reviews your symptoms, daily activities and any previous scans or treatment.
He scans your wrist with ultrasound, and arranges an X-ray or MRI if needed.
He explains the findings and discusses your options, including splinting and activity changes.
If you decide to go ahead with an injection, it is done under ultrasound guidance, often at the same visit.
You receive aftercare advice and a written report, which can be shared with your GP or hand therapist.

Treatment options

Many people improve with simple measures, which are usually tried first:

Rest and activity changes: reducing the movements that trigger pain, and changing how you lift and grip where possible. For new parents, a physiotherapist or hand therapist can suggest ways of lifting and feeding that put less strain on the thumb.
Thumb splint: a splint that supports the thumb and wrist rests the tendons and often eases pain.
Hand therapy: guided exercises once the pain begins to settle.

If symptoms continue despite these measures, the options at LSRI include:

Ultrasound-guided steroid injection: a small dose of steroid is placed into the tendon sheath to reduce inflammation. Many people get good relief, although symptoms can return. Ultrasound guidance lets Dr Sankaye place the steroid accurately within the sheath, including both parts of the tunnel where there is a dividing wall. You can read more about tendon injections.
MSK specialist consultation: a detailed review of your symptoms, scans and previous treatment, with a clear plan.

If you are pregnant or breastfeeding, please tell us, so that we can discuss whether an injection is suitable for you at this time.

If symptoms persist despite splinting and injection, a small operation to release the tendon sheath may be considered. Dr Sankaye can advise when a hand surgeon’s opinion is worthwhile.

Questions about De Quervain's tenosynovitis

Why is it common after having a baby?

Lifting, holding and feeding a baby involves repeated gripping with the thumb stretched out, which loads these tendons heavily. Hormonal changes during pregnancy and after birth may also play a part. The condition often improves as the baby grows and lifting patterns change.

Is it the same as wrist arthritis?

No. De Quervain's affects the tendons and their sheath, while arthritis affects the joints. Arthritis at the base of the thumb can cause pain in a similar area, which is why imaging can be helpful in telling them apart.

How long should I wear a splint?

This depends on how severe your symptoms are and how you respond. Your physiotherapist or hand therapist will guide you, and Dr Sankaye can advise as part of your plan.

Can I use my hand after the injection?

Yes, for light everyday tasks. We usually suggest avoiding heavy or repetitive gripping for a few days and continuing to wear your splint if you have one.

Our clinics

Two clinics, one team

Dr Prashant Sankaye, Consultant MSK Radiologist, sees patients at Harley Street in central London and at our Northwest London clinic in Harrow. Call one number to book at either clinic.