BACKGROUND: De Quervain's tenosynovitis is a disorder characterised by pain on 
the radial (thumb) side of the wrist and functional disability of the hand. It 
can be treated by corticosteroid injection, splinting and surgery.
OBJECTIVES: To summarise evidence on the efficacy and safety of corticosteroid 
injections for de Quervain's tenosynovitis.
SEARCH STRATEGY: We searched the following databases: the Cochrane Central 
Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, Issue 2), 
MEDLINE (1966 to April 2009), EMBASE (1956 to April 2009), CINAHL (1982 to April 
2009), AMED (1985 to April 2009), DARE, Dissertation Abstracts and PEDro 
(physiotherapy evidence database).
SELECTION CRITERIA: Randomised and controlled clinical trials evaluating the 
efficacy and safety of corticosteroid injections for de Quervain's 
tenosynovitis.
DATA COLLECTION AND ANALYSIS: After screening abstracts of studies identified by 
the search we obtained full text articles of studies which fulfilled the 
selection criteria. We extracted data using a predefined electronic form. We 
assessed the methodological quality of included trials by using the checklist 
developed by Jadad and the Delphi list. We extracted data on the primary outcome 
measures: treatment success; severity of pain or tenderness at the radial 
styloid; functional impairment of the wrist or hand; and outcome of 
Finkelstein's test, and the secondary outcome measures: proportion of patients 
with side effects; type of side effects and patient satisfaction with injection 
treatment.
MAIN RESULTS: We found one controlled clinical trial of 18 participants (all 
pregnant or lactating women) that compared one steroid injection with 
methylprednisolone and bupivacaine to splinting with a thumb spica. All patients 
in the steroid injection group (9/9) achieved complete relief of pain whereas 
none of the patients in the thumb spica group (0/9) had complete relief of pain, 
one to six days after intervention (number needed to treat to benefit (NNTB) = 
1, 95% confidence interval (CI) 0.8 to 1.2). No side effects or local 
complications of steroid injection were noted.
AUTHORS' CONCLUSIONS: The efficacy of corticosteroid injections for de 
Quervain's tenosynovitis has been studied in only one small controlled clinical 
trial, which found steroid injections to be superior to thumb spica splinting. 
However, the applicability of our findings to daily clinical practice is 
limited, as they are based on only one trial with a small number of included 
participants, the methodological quality was poor and only pregnant and 
lactating women participated in the study. No adverse effects were observed.