Pain in the thumb, traveling up the wrist can be caused by inflammation of the sheath that wraps around the tendons of the Abductor Pollicis Longus muscle and the Extensor Pollicis Brevis muscle. This is usually caused by chronic microtrauma from repetitive use or forceful gripping. This type of injury is referred to as DeQuervain’s Tenosynovitis.

To test for this condition there is a simple test called Finkelstein. Start with the affected arm in front of you, make a fist with your thumb pointing towards the ceiling. Then, point the thumb down, closing it inside your hand with your fingers. Deviate your wrist down towards the ground. If it causes pain the test is positive for DeQuervain’s Tenosynovitis.

Treatment involves activity modification, Active Release Techniques to break up adhesions along the tendon sheath and anti-inflammatory drugs. Failure to improve within 3-4 weeks may require immobilization with a thumb spica for another 3-4 weeks. If ineffective, local steroid injection would be the next step. Surgery is rarely needed.