Surgery for de Quervain’s is considered when splinting, activity modification, and steroid injection have not provided lasting relief. The procedure releases the tight compartment that constricts the tendons at the wrist.
This appointment is usually 1-2 weeks before surgery. The procedure is a day case, often performed under local anaesthetic.
A nursing team member will confirm your medical history, check your blood pressure and pulse, and answer any final questions.
The wrist is marked at the site of the radial tendons. Both sides are not usually operated on simultaneously.
Most medications continue as normal. Anticoagulants may need temporary adjustment - your team will provide specific instructions.
Local anaesthetic is the most common choice. The wrist is fully numb during the operation but you remain awake.
Let your surgeon know if you have had a steroid injection in the past 3 months, as the tissue may be more delicate.
You will be given a specific arrival time. Have no food from 2am on the day of surgery; you may drink clear water until 6am, unless your team gives you different instructions. Bring your medication list and any documents from the hospital.
You will be admitted to the day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist. Many hand procedures are done under local or regional anaesthetic; some require general anaesthesia.
After surgery you will spend time in the recovery area where nurses monitor your vital signs until you are stable and comfortable.
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
Important: A small superficial branch of the radial nerve runs close to the surgical area. Temporary numbness on the back of the thumb is common and usually settles. Persistent or worsening numbness should be reported to your surgical team.
Avoid getting the wound wet until it is fully healed - usually 10-14 days. Use a waterproof cover when showering. Follow the dressing instructions you are given.
Keep the hand raised above the level of your heart as much as possible for the first 48-72 hours. This significantly reduces swelling, pain, and stiffness.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, and ibuprofen if appropriate for you) is more effective than waiting.
Unless told otherwise, gently bend and straighten all fingers regularly. Early movement helps prevent stiffness and reduces swelling.
Seek urgent advice if you develop spreading redness, increasing pain, swelling, discharge from the wound, a temperature above 38°C, or any new numbness - these may indicate infection or nerve problems.
Recovery timelines vary between patients and depend on the operation, the demands you place on the hand, and any other health conditions. The timeline below is a general guide - your surgical and hand therapy team will give you personal advice.
Brief nursing review and consent paperwork.
A short procedure of approximately 15-20 minutes. Discharge home a few hours later.
The wrist is bandaged for several days. Gentle thumb and finger movements are encouraged early.
Hand therapists guide stretching and gradual strengthening. Heavy gripping is avoided initially.
Most patients return to full activity by 6-12 weeks. Some scar tenderness can persist longer.
A bulky bandage is usually used for the first few days, sometimes replaced by a removable splint for comfort. Strict immobilisation is not normally required.
De Quervain’s is common in new parents. Light lifting with both hands is often possible within 2-3 weeks. Avoid one-handed lifting of a child until your surgeon confirms it is safe.
Recurrence after surgery is uncommon. Adequate release of the compartment, combined with activity modification, gives lasting relief in most patients.
A week-by-week guide to recovery. Individual timelines vary, so always follow the advice of your surgical and hand therapy team.
The aim of surgery is to relieve the pain on the thumb side of the wrist by opening up the tight tunnel (the first dorsal compartment) so the thumb tendons glide freely again. Most patients get lasting relief of pain and can use the thumb and wrist normally.
The operation is usually a short day-case procedure under local anaesthetic. A small incision is made over the thumb side of the wrist and the roof of the first dorsal compartment is divided to release the two thumb tendons. The surgeon looks for and releases any separate sub-sheath around the extensor pollicis brevis tendon, and takes care to protect the small branches of the radial sensory nerve that lie just under the skin here.
A thumb spica splint and avoiding aggravating movements settles around half of cases, especially when started early.
A targeted injection is highly effective, with roughly 70 to 80 per cent of cases settling after a single injection, particularly when given accurately under ultrasound guidance.
Acceptable if symptoms are mild. The pain may persist and limit thumb use, but there is no serious harm in delaying.
The small nerve branches supplying the back of the thumb can be bruised or injured, causing numbness or, rarely, a tender area (neuroma). This is the most important specific risk of this operation.
If a separate sub-compartment around one tendon is not opened, symptoms can persist. The surgeon checks for this during the procedure.
Rarely the released tendons can snap forwards over the bone with movement. This may need a further procedure if troublesome.
Usually a superficial wound infection that settles with antibiotics.
Temporary numbness or tingling is common while the small nerve branches recover, and usually settles over weeks to months.
The scar can be firm and tender for a few weeks. Scar massage once healed helps it settle.
Some swelling of the wrist and thumb is normal in the early weeks.
Many cases of De Quervain settle with a splint and a steroid injection, so surgery is only considered when these have not given lasting relief. Without surgery the pain may continue and limit gripping and lifting, but the condition is not dangerous and there is no harm in trying non-operative treatment for longer before deciding.