De Quervain's & Neck Connection: The One Exercise You Must Try
Key insights: 60-second read
- De Quervain's tenosynovitis is often treated as a local thumb issue - but the neck may hold the keys to both its onset and persistence.
- Subtle neck dysfunction can exist without local pain or stiffness - yet still affect the nerves that supply the thumb tendons.
- One simple lacrosse ball exercise for the neck can be instantly effective - addressing the root cause rather than just the symptoms.
- Local + telehealth support available - personalised physio assessment in Port Macquarie or via video consult.
When dealing with de Quervain's tenosynovitis, we obviously spend the majority of our time treating the overloaded and irritated thumb tendons. And it makes perfect sense. The painful area is obviously specific to the thumb.
However, I'm finding that the neck may hold the keys to explaining both the onset and persistence of de Quervain's tenosynovitis. The neck itself may not feel overtly sore or stiff. But when assessing the area, there's clearly some specific restriction there. It's truly interesting stuff.
It's important enough that treating this subtle neck dysfunction has completely revolutionised how I treat not only thumb tendonitis-type pain, but repetitive strain injuries as a whole. So with this in mind, it's fair to say that successful treatment might look a little different from what's currently out there in the industry at the moment.
But hopefully, videos like this might help shift the conversation a little. In this video, I discuss the seemingly hidden link between lower neck dysfunction and de Quervain's tenosynovitis. Furthermore, I demonstrate one exercise that you are most likely not doing - but absolutely should. I'd almost go as far as to say it's a must-try. It's simple and instantly effective.
On this page
Video: The Hidden Neck Connection to De Quervain's
Topics Covered in This Video
- What is de Quervain's Tenosynovitis
- Finkelstein's Test for de Quervain's
- How the neck affects thumb pain
- Lacrosse Ball Neck Stretch
What is De Quervain's Tenosynovitis?
De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist. Specifically, it involves the abductor pollicis longus and extensor pollicis brevis tendons. These tendons share a common sheath, and when irritated, the sheath becomes inflamed and thickened, making thumb and wrist movement painful.
Typical symptoms include pain at the base of the thumb, swelling, and difficulty with grasping, pinching, or twisting motions. The classic diagnostic test is Finkelstein's test, where you tuck your thumb into your fist and bend your wrist toward your little finger - sharp pain along the thumb side indicates de Quervain's.
The Hidden Neck Connection
The nerves that supply the muscles and skin of the thumb originate from the lower cervical spine - specifically nerve roots C6, C7, and C8. These nerves exit between the vertebrae and travel down the arm, passing through various muscles and tight spaces before reaching the thumb.
When the joints of the lower neck become stiff or restricted - even without causing local pain - they can create subtle changes in nerve function. It's not always a dramatic compression. More often, it's a loss of normal mobility around the nerve root that dampens the signal or alters muscle tone, similar to a dimmer switch rather than an on-off button.
This can lead to:
- Altered muscle activation patterns in the thumb and forearm
- Increased resting tone in the affected muscles
- Poor coordination of the tendons during repetitive tasks
- A lowered threshold for irritation and inflammation
The thumb tendons become the "victim" of a problem originating further up the chain. This is why treating only the wrist and thumb often provides incomplete or temporary relief - the underlying neural dysfunction remains unaddressed.
The Must-Try Exercise: Lacrosse Ball Neck Stretch
This simple yet powerful technique targets the stiff joints in the lower neck that may be affecting thumb function. Here's how to do it:
- Get a lacrosse ball - a tennis ball can work, but a lacrosse ball is firmer and more specific.
- Find the right spot - Lie on your back and place the ball under your neck, just to one side of your spine. You're targeting the small joints between the vertebrae, not the spine itself.
- Apply gentle pressure - Let your head relax and allow the ball to press into the tissue. Do not roll around - the goal is sustained, gentle pressure.
- Assess and compare - Pay attention to how the spot feels. Compare it to the same spot on the other side. One side will almost certainly feel stiffer, tighter, or more "dense."
- Hold and breathe - Stay on the stiff spot for 60-90 seconds, breathing deeply. The goal is to feel the tissue slowly "give" and soften.
- Re-test your symptoms - After working on the spot, gently test your thumb pain (e.g., with Finkelstein's test). Has anything changed? Even a slight improvement is a powerful sign that you've found a relevant dysfunction.
The key insight from the video: the stiff side may not be the same side as your thumb pain. Your body is an interconnected system. In many cases, stiffness on the right side of the neck can affect the left thumb, and vice versa.
Related: Instantly Improve Your Neck Mobility with this Muscle Energy Technique (MET) - another effective approach for neck restrictions.
Equipment used in this video
- Lacrosse Ball - for mobilising stiff neck joints
Please note: This is an affiliate link. I may earn a small commission if you purchase through it, at no extra cost to you.
I genuinely hope this helps those struggling to shake their thumb pain. Please feel free to let me know how you're going in the comments. I'd love to be able to help where I can!
If you found this video useful, please leave a like and let me know in the comments! Also, please consider subscribing to the Your Wellness Nerd channel for more helpful information.
- Grant
Frequently Asked Questions
Can a stiff neck really cause thumb pain?
Yes, absolutely. The nerves that control thumb function originate in the lower neck. Stiffness in these spinal segments can affect nerve signalling, altering muscle tone and coordination in the thumb and forearm. This can set the stage for tendon irritation, even without neck pain.
How often should I do the lacrosse ball neck exercise?
Daily can be very helpful, especially in the initial stages. Even 5 minutes a day can make a significant difference. Focus on the stiff spots you identify, and be consistent. As symptoms improve, you can reduce frequency to a few times per week for maintenance.
Do I still need to treat my thumb directly?
Addressing the neck is a crucial piece, but it doesn't necessarily replace local care. Many people benefit from a combined approach - mobilising the neck to address the root cause, while also using gentle thumb/wrist stretches, activity modification, and perhaps splinting as needed. A physiotherapist can help you create a comprehensive plan.
One key insight
"The neck may hold the keys to explaining both the onset and persistence of de Quervain's tenosynovitis. Treating subtle neck dysfunction has revolutionised how I approach repetitive strain injuries - because the thumb tendons are often just the victims of a problem further up the chain."
Struggling With Persistent Thumb or Wrist Pain?
If you'd like help uncovering the underlying cause of your pain - whether it's de Quervain's or another issue - a thorough assessment can help. Learn more about our forearm, hand & wrist pain physiotherapy services in Port Macquarie.
Want personalised guidance?
If you'd like help with your thumb pain or any other persistent issue, you can book with Grant either in Port Macquarie or via an online telehealth consultation.
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