A woman in her 20s from Kannai, Yokohama, came in with pain around the base of her right thumb.
The orthopedic doctor diagnosed her with De Quervain’s tenosynovitis, explaining that the tendons in her thumb were inflamed. She was prescribed anti-inflammatory medication and advised to return for a follow-up visit the following week.
Since her symptoms had not improved by the next visit, she was provided with a thumb support brace and instructed on therapeutic exercises to manage the condition.
She visited the hospital three more times (a total of five visits), and eventually received a corticosteroid injection, which brought dramatic relief. However, the symptoms recurred about a month later. This cycle repeated: steroid injection, temporary improvement, and then recurrence within a month.
As she continued to experience significant pain when using her hand, she searched online for more information about her symptoms and came across a case study on wrist pain on my clinic’s website. This led her to decide to try chiropractic care and visit my clinic.
[Initial Symptoms]
- Interview: Since she’s in the middle of raising a child, she often has to carry and hold her baby — and every time she does, she feels a sharp pain in her wrist. She said it’s been really tough on her emotionally too. Even simple things like cooking — holding a frying pan or using a knife — cause pain, so she’s been getting by with painkillers and a wrist brace. The treatments at the hospital did help for a while, but the pain kept coming back. She looked exhausted, both physically and mentally, and it felt like what she really needed was a more long-term, fundamental fix — not just temporary relief.
- Visual Inspection: Nothing unusual was seen during the visual check.
- Static Palpation:
- There was tenderness when pressing on the tendon of the right thumb.
- The right forearm overall felt tighter than the left side.
- The muscles around the base of the thumb (thenar area) were also quite tight.
- Motion Palpation:
- Moving the thumb inward caused more pain than lifting it up.
- The wrist bones on the thumb side—the scaphoid and trapezium—were slightly out of alignment.
- Orthopedic Tests: No specific orthopedic tests were applicable.
- Muscle Strength Examination: Extension of the thumb tendons could not be assessed due to pain.
Flexor muscles of the thumb demonstrated mild pain, but muscle strength was preserved. However, the act of flexing the thumb itself elicited significant pain.
[Initial Treatment Plan]
Since there was a lot of pain during the session, I focused mainly on gentle, conservative treatment for the first visit.
I used ultrasound therapy with a program designed to reduce inflammation.
Ideally, I want to address the root cause of the issue, but if I don’t calm down the inflammation in the thumb tendons first, there’s a chance it could get worse after treatment.
So for the first session, I aimed to reduce inflammation and loosen up the forearm and thumb-related muscles.
After the treatment, I taped the area to reduce strain on the tendon, and asked the patient to come back in 3–4 days after seeing how things go.
[Prognosis]
2nd Visit (4 days later):
When I asked her how she was feeling, she said:
“The pain is still there, but it’s a little better than before.”
I asked, “If your original pain was a 10, what is it now?”
She replied, “Maybe a 7? But for a couple of days, it felt more like a 5.”
Since there was some improvement, I continued with the same treatment focused on reducing inflammation and loosening up her forearm muscles. This time, I asked her to come back in a week.
3rd Visit:
Just like before, she felt better for 2–3 days, but the pain returned to its original level. Since we now knew the pain wasn’t getting worse, I decided to work on correcting the alignment of the wrist (carpal) joints, which seemed to be the underlying issue. After the session, I taped the area to keep the joints stable.
4th Visit (One week later):
She seemed to be doing much better this time. She had been taping at home, too, and said,
“I got through this week with less than half the pain I had before.”
She had a hospital appointment scheduled a few days later, so we decided her next session would be in a month.
5th Visit (One month later):
Although some pain remained—probably because her child was getting heavier—she said it was much more manageable than before.
For this session, I:
Relaxed her forearm and hand muscles
Realigned her wrist joints (which tend to shift after two weeks)
Started working on her elbow as well (since structures going to the hand pass through the elbow)
At-home Training:
I taught her some simple exercises to strengthen the gripping muscles in her hand. This helps calm down the overused extensor muscles through something called reciprocal inhibition.
Book Hold: Pinch a book with your fingertips and hold for 20 seconds × 3 sets
Flat Surface Pinch: Grab a flat surface like a desk using only your fingers, 20 times × 3 sets
I asked her to practice these every day.
6th Visit (One month later):
After the last session, she felt great again. She’d done the exercises daily and said she hardly had any pain at all during the month.
Now, her wrist pain is basically gone—she’s stopped going to the hospital and no longer needs a wristband.
We’re continuing with monthly maintenance sessions to keep everything in good shape.
[Practitioner’s Opinion]
De Quervain’s syndrome can affect anyone, no matter their age or gender. That said, it tends to show up more often in women—especially during pregnancy or while caring for young children.
Why? Mainly because women generally have less muscle mass than men but are often doing a lot of lifting (like picking up a child), cooking, or putting weight on their wrists when getting up from a chair—especially during pregnancy. All of these everyday actions can put a lot of stress on the wrists.
De Quervain’s is one of the conditions that can easily develop when the wrists are overused like this.
In this particular case, that kind of daily lifestyle strain was definitely a trigger. What stood out was that the alignment between two wrist bones—the scaphoid and trapezium—was off. That misalignment was putting constant stress on the thumb’s abductor and extensor muscles, which led to inflammation and pain.
Even though the inflammation was being treated at the hospital, the real cause—the misaligned wrist joint—was still there, so the pain kept coming back.
It’s not uncommon for joint alignment issues like this to be at the heart of De Quervain’s symptoms. In this case, using chiropractic joint motion techniques (like those I apply to the spine) made a big difference.
Still, because childcare is a long-term responsibility that can’t be avoided, it was clear that muscle strengthening had to be part of the solution. (Since you can’t reduce the workload, the body has to get stronger to handle it better.)
At Spine Chiropractic, I address a wide range of musculoskeletal conditions directly impacting daily life, not merely as a form of relaxation therapy. Conveniently located within a one-minute walk from Bashamichi Station, an eight-minute walk from Nihon-Odori Station, a seven-minute walk from JR Kannai Station, and a 12-minute walk from JR Sakuragicho Station, my clinic is well-suited for residents and workers in the Yokohama area.
If you are experiencing similar symptoms, please feel free to visit Spine Chiropractic. I am committed to providing care with sincerity and professionalism.