What is De Quervain's tenosynovitis?

De Quervain's tenosynovitis is a painful condition affecting two tendons on the thumb side of the wrist. The tendons and their surrounding sheath become inflamed and thickened, making thumb and wrist movement painful — particularly with gripping, pinching and lifting. It is one of the most common wrist and hand conditions seen in physiotherapy.

What does De Quervain's tenosynovitis feel like?

Most people describe pain and tenderness at the base of the thumb on the wrist side, that worsens with gripping or pinching. Some notice swelling, stiffness or a snapping sensation when moving the thumb. Pain can radiate up the forearm and is often worse first thing in the morning or after repetitive hand use.

How long does De Quervain's tenosynovitis take to heal?

Many people see significant improvement within 6 to 12 weeks of appropriate physiotherapy. Longstanding or severe cases may take longer. Continuing to overload the tendons without modification tends to prolong recovery.

Is De Quervain's tenosynovitis common in new mothers?

Yes — it is very common in new parents, particularly mothers. Repeatedly lifting an infant using a thumbs-up grip places high load on the tendons at the base of the thumb. Hormonal changes during pregnancy and the postpartum period also affect tendon tissue, increasing susceptibility. The condition is sometimes called mother's wrist for this reason.

Does De Quervain's tenosynovitis go away on its own?

It can improve over time with rest and activity modification, but without addressing the underlying load and movement factors, symptoms often persist or recur. Physiotherapy helps speed recovery, reduce pain and prevent the condition from becoming chronic.

What is the Finkelstein test?

The Finkelstein test is a clinical assessment used to diagnose De Quervain's tenosynovitis. It involves folding the thumb into the palm, wrapping the fingers around it, and tilting the wrist toward the little finger side. Pain along the thumb side of the wrist with this movement is a strong indicator of De Quervain's tenosynovitis.

Is cortisone injection necessary for De Quervain's tenosynovitis?

Not always. Many people recover well with physiotherapy alone. A cortisone injection may be considered if symptoms are severe or not responding to conservative management. Injections tend to work best when combined with a rehabilitation programme rather than used in isolation.

Can De Quervain's tenosynovitis affect both wrists?

Yes, though it most commonly affects one side. Bilateral De Quervain's can occur, particularly in new parents who are repeatedly lifting with both hands, or in people with inflammatory conditions such as rheumatoid arthritis.

What is a SLAP lesion?

A SLAP lesion is a tear of the superior labrum — the ring of cartilage that lines the top of the shoulder socket. The tear runs from the front to the back of the labrum at the point where the biceps tendon attaches. SLAP lesions can cause deep shoulder pain, clicking and instability, particularly with overhead or throwing activities.

Can a SLAP tear heal without surgery?

Many SLAP tears, particularly lower-grade or degenerative tears, can be managed successfully with physiotherapy without surgery. A structured rehabilitation programme focusing on rotator cuff strength, scapular control and load management can lead to excellent outcomes. Higher-grade tears in younger competitive athletes may require surgical repair, but this is assessed case by case.

How long does recovery from a SLAP lesion take?

Recovery time varies depending on whether the injury is managed conservatively or surgically. Physiotherapy-managed SLAP lesions may show meaningful improvement within 3 to 6 months. Post-surgical recovery from a SLAP repair typically takes 4 to 6 months or longer before return to overhead sport.

How is a SLAP lesion diagnosed?

A SLAP lesion is suspected based on clinical assessment including history and specific shoulder tests. An MRI — often with contrast injected into the joint (MRI arthrogram) — is the most common imaging used to confirm the diagnosis.

Is a SLAP lesion the same as a labral tear?

A SLAP lesion is a specific type of labral tear occurring at the top (superior) portion of the labrum. Other labral tears can occur at the front (Bankart lesion) or the back of the socket. The location and type of tear determines the symptoms and treatment approach.

Can I still exercise with a SLAP lesion?

In most cases, yes — with appropriate modifications. A physiotherapist can guide you on which exercises are safe, which to avoid and how to progressively load your shoulder during recovery. Complete rest is rarely required and often counterproductive.

What happens if a SLAP lesion is left untreated?

An unmanaged SLAP lesion can lead to ongoing pain, progressive instability and difficulty returning to sport or work. Compensatory movement patterns may develop over time, placing excess load on surrounding structures. Early assessment and appropriate management leads to better outcomes.

Ankylosing Spondylitis Treatment Adelaide

Back Pain Physiotherapy St Marys

Do you have lower back pain and stiffness that’s worst in the morning or after rest, and eases once you get moving? Pain that wakes you in the second half of the night?

These can be signs of ankylosing spondylitis, an inflammatory condition of the spine. Living with a long-term condition can be tiring and frustrating, but staying active is one of the best ways to manage it. At Active Balance, we work alongside your GP and rheumatologist with tailored exercise, hands-on treatment and practical strategies to help you stay mobile, strong and doing what you love.

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Ankylosing Spondylitis Treatment in Adelaide

What Is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a long-term inflammatory condition that mainly affects the spine and the sacroiliac joints, where the spine meets the pelvis. It’s part of a group of conditions now often called axial spondyloarthritis.

In AS, the immune system causes inflammation in the joints and where ligaments and tendons attach to bone. Over time, this can lead to stiffness and reduced spinal movement. In some people, parts of the spine may gradually fuse together.

Unlike mechanical back pain, AS pain usually improves with movement and gets worse with rest. That’s why exercise is such an important part of managing it.

AS is diagnosed and medically managed by a GP and rheumatologist. Physiotherapy plays a key role alongside medical care.

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Who Does Ankylosing Spondylitis Affect?

Symptoms usually start in late teens to mid-40s, and rarely start after 45
It’s diagnosed more often in men, but women are affected too and are often diagnosed later
People with a family history of AS or related conditions
People who carry the HLA-B27 gene, which is linked with AS (though many people with this gene never develop it)
People with related conditions, such as psoriasis, inflammatory bowel disease or uveitis (eye inflammation)

Contributing Factors & Causes

The exact cause of AS isn’t fully understood, but it’s thought to involve a mix of:

Genetics, particularly the HLA-B27 gene
Immune system factors that drive inflammation
Family history

Smoking is linked with more severe symptoms and faster progression.

AS is not caused by injury, posture, your job or the sport you play.

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Symptoms & Signs

Lower back and buttock pain that has come on gradually over months
Morning stiffness lasting more than 30 minutes
Pain and stiffness that improve with exercise and get worse with rest
Night pain, often waking you in the second half of the night
Buttock pain that may alternate between sides
Pain at tendon attachments, such as the heel, Achilles or bottom of the foot
Fatigue
Reduced flexibility in the spine and difficulty taking a deep breath, in more advanced cases
Red, painful eyes (uveitis) in some people

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How Physiotherapy Can Help Manage Ankylosing Spondylitis

Exercise and physiotherapy are recommended as a core part of managing AS, alongside medical treatment from your rheumatologist.

Education and support help you understand your condition and how to manage flare-ups, so you feel more in control day to day.
Mobility exercises help maintain movement through the spine, hips and shoulders. Keeping your spine moving through its full range is especially important with AS.
Strengthening and posture work target the muscles that support an upright posture, particularly the back extensors, hips and core.
Breathing and chest exercises help maintain rib cage movement and lung capacity.
Hands-on treatment, including gentle mobilisation and soft tissue work, can ease stiffness and pain. Treatment is always tailored to your presentation and stage of the condition.
A long-term home program is essential. AS responds best to regular movement, so we’ll help you build a realistic routine that fits into your life. Our group classes, such as Clinical Mat Pilates and Move Well For Life, can also be a great way to stay consistent.

How Massage & Myotherapy Can Help

Ongoing stiffness and altered posture can lead to muscle tension through the back, neck, hips and shoulders. Remedial massage and myotherapy can ease this tension, improve comfort, and support your exercise program.

Our massage and myotherapy team works closely with your physio so treatment is suited to your condition and supports your overall care.

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When to Seek Further Medical Advice

If you think you might have AS, see your GP. Early diagnosis and medical treatment can make a big difference to long-term outcomes.

Seek urgent medical care if you have:

A painful, red eye, blurred vision or sensitivity to light, which may be uveitis and needs prompt treatment
Sudden new back or neck pain after a fall or minor knock, as a stiff spine is more prone to fracture
Numbness, tingling or weakness in the arms or legs, or changes to bladder or bowel control

See your GP or rheumatologist if you have:

Back pain and stiffness that fit the pattern above and haven’t been investigated
A flare-up that isn’t settling
New joint swelling, or worsening fatigue or symptoms despite treatment

If anything in your assessment suggests further investigation is needed, we’ll refer you to your GP or rheumatologist.

Prognosis

AS is a lifelong condition, but many people live full, active lives with the right management.

Medical treatments have improved significantly and can be very effective at controlling inflammation
Regular exercise is one of the most important factors in maintaining mobility, posture and function
Symptoms often come and go, with flare-ups and calmer periods
Early diagnosis and consistent management give the best long-term outcome

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Why Choose Active Balance Physio & Wellness?

Physio-led integrated care

Physio, massage, myo & rehab under one roof

Individualised treatment plans

Friendly, caring team focused on results

Convenient Adelaide location

After-hours appointments available

Frequently Asked Questions

Q: Did I do something to cause this?
No. AS is an inflammatory condition linked to genetics and the immune system. It isn’t caused by your posture, your job, an injury or anything you did. What you do now can make a real difference, though, and staying active is one of the most helpful things for managing it.

Q: Should I rest when my back is sore?
Usually not. Unlike many types of back pain, AS tends to feel better with movement and worse with rest. During a flare-up, you may need to adjust your exercise, but gentle movement is generally better than staying still.

Q: What kind of exercise is best?
A mix of mobility, strengthening, posture and breathing exercises is ideal. Swimming and water-based exercise are often very comfortable. Your physio will build a program that suits your symptoms, goals and lifestyle.

Q: How is AS diagnosed?
Diagnosis is made by a GP and rheumatologist, usually based on your symptoms, blood tests and imaging such as X-rays or MRI. If your physio suspects AS, we’ll let you know and recommend you see your GP.

Q: Can I still play sport?
Many people with AS keep playing sport and staying active. Your physio and rheumatologist can help you choose activities that suit you, and modify them during flare-ups if needed.

Related articles:

Why "Just Resting" an Injury Usually Isn't Enough

Why we love sports injuries

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Living with ankylosing spondylitis doesn’t mean giving up the things you love. With the right support and a tailored exercise program, you can stay moving, stay strong, and feel more in control.

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