Treatment of Wrist Tendonitis & De Quervain’s Tenosynovitis Using LLLT/PBMT
Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), uses red and near-infrared light applied over targeted areas. In our clinic it is used as part of a GP-led treatment approach for selected musculoskeletal pain and injury presentations, including wrist tendonitis and De Quervain’s tenosynovitis.
PBMT/LLLT is non-invasive and generally well tolerated. Suitability and response vary, and treatment recommendations depend on the diagnosis, severity, duration of symptoms and individual clinical factors. PBMT/LLLT has been studied for a range of musculoskeletal pain and injury conditions.
See our references page for supporting literature.
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Key Points
- Wrist tendonitis involves inflammation or degeneration of tendons from overuse or repetitive movement, most commonly on the thumb side of the wrist.
- De Quervain’s tenosynovitis is a specific type of tendonitis affecting the tendons that control thumb movement, often presenting with pain and swelling at the base of the thumb.
- Typical symptoms include pain with gripping, pinching, wrist motion, or lifting, especially with twisting or thumb use.
- Common causes include overuse, heavy lifting, prolonged computer or mouse use, and hormonal changes such as the postpartum period.
- Standard treatments such as splints, anti-inflammatories and injections may reduce symptoms short-term, but are not suitable or sufficient for every presentation.
- Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected wrist tendonitis and De Quervain’s presentations where tendon irritation, pain or local inflammatory processes are contributing to symptoms.
- LLLT may be particularly relevant for chronic or irritable wrist conditions where rest alone is insufficient or impractical, and where loading, stretching or repeated hand use can aggravate symptoms.
- Some commonly used approaches, such as splints, medication, injections, repeated loading, exercises or manual pressure, may not be suitable for every stage of recovery. We provide advice based on the diagnosis, symptom severity and clinical assessment.
- Treatment is supervised by Dr Shikha Parmar and delivered through a structured six-week program tailored to wrist and thumb tendon issues.
- PBMT/LLLT has been studied in a range of musculoskeletal pain and injury conditions and is generally well tolerated. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery.
- LLLT can be considered for people with persistent wrist tendonitis or De Quervain’s tenosynovitis who have not improved with usual conservative care, after appropriate medical assessment.
What is Wrist Tendonitis?
Wrist tendonitis refers to inflammation, irritation, or degeneration of the tendons that cross the wrist joint, typically due to repetitive stress. It often involves the extensor or flexor tendons that allow for gripping, pinching, and rotating motions.
What is De Quervain’s Tenosynovitis?
De Quervain’s affects the two tendons at the base of the thumb, the abductor pollicis longus and extensor pollicis brevis, causing pain and thickening near the thumb side of the wrist. It commonly occurs in new parents, manual workers, or anyone whose activities involve repetitive thumb motion.
Causes and Risk Factors
- Repetitive hand and wrist movements
- Prolonged or forceful gripping (e.g. tools, lifting, childcare)
- Poor wrist posture during computer or mouse use
- Hormonal changes and fluid retention, such as postpartum
- Inadequate rest between repetitive tasks
- Sudden increase in physical activity
Symptoms
- Pain on the thumb side of the wrist (radial side)
- Pain with gripping, pinching, or wrist motion
- Swelling or tenderness at the base of the thumb
- Difficulty with lifting or twisting actions, such as jars or kettles
- Pain on thumb extension or resisted movement
- Positive Finkelstein’s test, with pain when stretching thumb tendons
How is Wrist Tendonitis Diagnosed?
Diagnosis is typically clinical and based on:
- Thorough history of activity, pain, and functional limitations
- Physical examination, including palpation and resisted movements
- Specific tests such as the Finkelstein’s test for De Quervain’s
Imaging may be used to confirm diagnosis or rule out other causes:
- Ultrasound to visualise tendon thickening or sheath fluid
- X-rays to rule out joint or bony abnormalities
- MRI in complex or chronic cases
Note: If pain is ulnar-sided, on the little finger side, a TFCC injury may be considered. See our dedicated TFCC Injury page.
Wrist Tendonitis & De Quervain’s Tenosynovitis – Treatment Overview
Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a non-invasive treatment approach used as part of a structured program for selected wrist tendonitis and De Quervain’s tenosynovitis presentations. It may help modulate pain and local inflammatory processes and support tendon and soft tissue recovery without adding mechanical stress to already irritated tendon tissue.
Why Consider Low Level Laser Therapy (LLLT)?
Many patients present after limited relief from splinting, physiotherapy, massage, exercises, or anti-inflammatory medication. These approaches may ease symptoms temporarily, but are not suitable or effective for everyone, especially if loading or exercise is introduced too early or aggravates sensitive tendon tissue.
Why ice, anti-inflammatories, cortisone, and PRP may not support long-term recovery. Read more here.
How LLLT Supports Healing
LLLT uses red and near-infrared light and may support:
- Helping modulate inflammation and oxidative stress
- Local circulation and oxygenation
- Lymphatic drainage
- Cellular energy production (ATP)
- Tendon and soft tissue recovery processes where irritation is present
- Assisting pain reduction without mechanical loading or stressing the wrist or thumb tendons
Non-Invasive and Supported by Research
PBMT/LLLT is non-invasive and generally well tolerated. It has been studied in a range of musculoskeletal pain and injury conditions. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery. Read more here.
See how LLLT may support the cellular environment involved in tissue recovery here.
Our Treatment Program
All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:
- Up to 12 LLLT sessions
- Early progress review after the first 6 treatments
- Individualised advice and activity modification
- Guided rehabilitation to support longer-term function
Progress is reviewed during the program. Many patients notice appreciable improvement after the first 6 treatments. If there has not been sufficient improvement by this review point, further treatment may not be recommended.
View the full treatment protocol and expected outcomes here.
Ready to Discuss Your Wrist Tendonitis or De Quervain’s Treatment Options?
If you are struggling with persistent pain from wrist tendonitis or De Quervain’s tenosynovitis, we invite you to contact our team at Laser Pain Therapy to discuss the suitability of LLLT for your presentation. Treatment suitability and outcomes vary, and assessment is required before recommendations can be made.
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