The Finkelstein test, also called the Finkelstein sign or maneuver, is used to diagnose de Quervain’s tenosynovitis. This is a common condition characterized by swelling and pain in two of the tendons in your wrist that attach to the base of your thumb. Experts
Doctors, physiotherapists, and other trained professionals use the Finkelstein test to differentiate de Quervain’s tenosynovitis from other wrist conditions. The practitioner performs the test in three stages, moving your hand into certain positions. Pain in these positions is a sign that you have de Quervain’s tenosynovitis.
Read on to learn more about how medical professionals perform the Finkelstein test and why they use it.
What is de Quervain’s tenosynovitis?
If you open your hand as wide as you can, you may see a triangular indent at the base of your thumb. This space is nicknamed the anatomical snuffbox. De Quervain’s tenosynovitis is swelling of the two tendons at the bottom of this area called abductor pollicis brevis and extensor pollicis brevis.
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Medical professionals usually perform the Finkelstein test in three stages with increasing levels of pressure.
The practitioner will instruct you to move your arm so that your wrist is at the end of the treatment table and your thumb is facing up. You’ll perform all three stages of the test from this position.
In this stage, the practitioner will ask you to relax your forehand. If you have severe inflammation, you might feel pain in this position.
If stage 1 doesn’t cause pain, the practitioner will apply gentle downward pressure to your hand to assess whether you experience pain.
If you don’t experience pain in the first two stages, your practitioner will perform the original version of the test. They will grasp your thumb and flex it into the palm of your hand and ask if you feel pain.
The test is positive if you feel pain at the radial styloid during any stage of the test. The radial styloid is just above the base of your thumb at the outer end of your radius. The radius is the forearm bone closest to your thumb.
A positive test suggests that you have de Quervain’s tenosynovitis. A negative test suggests you don’t.
Many health professionals, textbooks, and journals confuse the Finkelstein test with another test called Eichhoff’s test.
During Eichhoff’s test:
- The test practitioner will position your hand at the end of the table in the same way as in the Finkelstein test.
- They will then ask you to make a fist with your fingers wrapped around your thumb.
- They will stabilize your wrist and apply a gentle force downward to the top of your hand to see if you feel pain.
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De Quervain’s tenosynovitis often goes away when you stop activities that caused it. For example, it may subside in new parents who are breastfeeding or chestfeeding once they stop lifting their child as frequently.
If pain is persistent, your doctor might recommend:
- anti-inflammatory medications
- corticosteroid injections
Corticosteroid injections often provide complete relief after one or two injections. In a 2019 study, researchers found a short- and long-term success rate of
If the above options are not effective, a doctor may recommend surgery. A 2022 review found that surgical release of the tendon sheaths eliminated pain in 95% of people.
Here are some common questions people have about the Finkelstein test.
Is the Finkelstein test accurate?
Experts consider the Finkelstein test more accurate than Eichhoff’s test. More large studies are needed to assess its accuracy. In a small 2019 study, researchers found false positives in 46.7% of cases of Finkelstein tests and 53.3% of cases of Eichhoff’s tests.
Can I perform the Finkelstein test on my own?
Only a trained medical professional should perform the Finkelstein test to get accurate results. If your wrist isn’t at the proper angle, the test can involve other structures and cause a false positive.
Will I need an X-ray to diagnose de Quervain’s tenosynovitis?
A medical professional can usually diagnose de Quervain’s tenosynovitis based on your symptoms and the results of a Finkelstein test. Imaging, such as X-rays, can help rule out other causes like arthritis.
Is de Quervain’s tenosynovitis a type of carpal tunnel syndrome?
De Quervain’s tenosynovitis is inflammation of the tendons in the wrist that connect to the base of your thumb. It isn’t a form of carpal tunnel syndrome, which is compression of the median nerve in the front of your wrist.
Medical professionals use the Finkelstein test to diagnose a common condition that causes wrist pain called de Quervain’s tenosynovitis. Practitioners perform the test by applying pressure to the side of your wrist to check for pain.
If the test suggests you have de Quervain’s tenosynovitis, your doctor may recommend treatments like a splint, anti-inflammatories, or corticosteroid injections. These treatments are generally very effective at managing pain.