De Quervain’s Tenosynovitis Is on the Rise in Central Wisconsin—What Workers Should Know

Over the past several months, we’ve seen a noticeable increase in De Quervain’s tenosynovitis cases here in Marathon and the surrounding Central Wisconsin communities. This trend mirrors what many healthcare providers are seeing nationwide, particularly in regions with a high percentage of repetitive-use occupations.

Manufacturing, agriculture, healthcare, childcare, office work, and skilled trades all place sustained demands on the wrist and thumb. Over time, these demands can exceed the tissue’s ability to recover—leading to pain, stiffness, and reduced function.

The good news: with early, evidence-based care, outcomes for De Quervain’s tenosynovitis are often very positive.

What Is De Quervain’s Tenosynovitis?

De Quervain’s tenosynovitis is a repetitive strain condition involving irritation of the tendons that control thumb movement as they pass through the first dorsal compartment of the wrist. As swelling and thickening occur, normal tendon glide becomes restricted.

Common symptoms include:

• Pain along the thumb side of the wrist

• Pain with gripping, pinching, lifting, or twisting

• Symptoms that worsen throughout the workday

• Reduced grip or thumb strength

Without appropriate care, symptoms can become chronic and interfere with both work and daily activities.

How De Quervain’s Tenosynovitis Is Diagnosed

Diagnosis is typically clinical, based on a detailed history and physical examination. Imaging is rarely required unless symptoms are atypical or not responding to care.

Key diagnostic components include:

Detailed History

We assess:

• Work tasks and repetitive hand use

• Onset and progression of symptoms

• Activities that worsen or relieve pain

• Prior treatments or self-management attempts

This step is especially important for repetitive-use workers, as job demands often drive both the condition and the recovery strategy.

Physical Examination

Evaluation focuses on:

• Localized tenderness along the thumb-side wrist

• Swelling or thickening over the tendon sheath

• Grip and thumb strength

• Movement patterns of the wrist, thumb, and forearm

Provocative Testing

The Finkelstein test and similar maneuvers are commonly used to reproduce symptoms and help confirm involvement of the affected tendons.

A precise diagnosis ensures care is directed at the correct tissue and reduces the risk of unnecessary or ineffective treatment.

Evidence-Based Care Across Healthcare Disciplines

Across chiropractic, physical therapy, occupational therapy, and sports medicine, best-practice care emphasizes conservative, active treatment before considering invasive options.

Common evidence-supported strategies include:

• Activity modification and load management

• Short-term splinting when appropriate

• Manual therapy and myofascial techniques

• Progressive strengthening and tendon loading

• Modalities such as extracorporeal shockwave therapy

Injections and surgical intervention are typically reserved for cases that do not respond to conservative care.

Why Focused Shockwave Therapy Has Been Especially Effective in Our Office

One of the reasons we’ve seen consistently strong outcomes is our use of focused shockwave therapy, combined with hands-on care and progressive rehabilitation.

Focused shockwave differs from radial pressure wave therapy by delivering precise energy directly to the affected tendon tissue. Research on chronic tendinopathies suggests shockwave therapy may:

• Stimulate tissue remodeling and healing

• Improve local blood flow

• Reduce pain sensitivity

• Support long-term functional improvement

For patients with persistent symptoms—especially those who have continued working through pain—shockwave can be a powerful tool to help break the chronic pain cycle.

When combined with targeted myofascial release, we aim to:

• Restore normal tendon glide

• Reduce surrounding tissue restriction

• Improve tolerance to daily work demands

Many patients experience meaningful improvement without the need for injections or surgical referral.

Helping Repetitive-Use Workers Stay Productive

In communities like Marathon, avoiding work altogether is often not realistic. Our goal is to help patients stay productive while protecting long-term wrist and thumb function.

Education, task modification, and a progressive return to full activity are key components of preventing recurrence.

If you’re experiencing thumb or wrist pain that worsens with work and hasn’t resolved on its own, early evaluation can make a significant difference in recovery time and long-term outcomes.