Comparative Study of Functional Outcome of Local Steroid Injection Versus Conservative Treatment in De Quervain's Disease: A Prospective Study

Open Access

Abstract

Background: De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the wrist that commonly causes radial-sided wrist pain and functional limitation. Both conservative treatment and local steroid injection are widely used, but comparative data from Bangladesh are limited. The current study aimed to compare the functional outcome of local steroid injection versus conservative treatment in patients with De Quervain's disease. Methods & Materials: This prospective comparative study was conducted from July 2024 to December 2025 at two healthcare setting in Rangpur. A total of 150 patients with tenosynovitis of the first dorsal compartment of the wrist and positive Finkelstein's test were included. The patients were divided into two groups: conservative treatment group (n=75), and steroid group (n=75). Baseline characteristics, pain severity, functional outcome, and adverse effects were assessed. Results: The mean age was 38.2 ± 8.1 years in the conservative group and 36.8 ± 7.9 years in the steroid group (p=0.286). Baseline VAS pain score was 7.3 ± 1.2 and 7.4 ± 1.1 respectively (p=0.596). Mean VAS pain score was 1.3 ± 0.7 in the steroid group versus 3.5 ± 1.4 in the conservative group (p<0.001). Mean DASH score was 14.2 ± 6.5 versus 32.4 ± 10.2 (p<0.001). Excellent or good outcome was achieved in 69.3% of the steroid group compared with 49.3% of the conservative group (p=0.013). Poor outcome was lower in the steroid group (10.7% versus 29.3%, p=0.004). Among steroid-treated patients, local fat atrophy occurred in 37.3%, hypopigmentation in 34.7%, and acute flare in 8.0%. Conclusion: Local steroid injection provided better pain relief and functional improvement than conservative treatment in patients with De Quervain's disease, although local adverse effects were relatively common.