This quasi-experimental study compared pain outcomes following local corticosteroid injection (CSI) versus open surgical release in 100 patients with clinically confirmed De Quervain tenosynovitis unresponsive to conservative management. Patients were allocated to treatment based on clinician judgment and patient preference. Pain was assessed using the Visual Analog Scale (VAS) at baseline, one month, and six months post-intervention. The study was conducted at a single tertiary care centre in Rawalpindi, Pakistan between March 2023 and April 2025.

De Quervain tenosynovitis is a stenosing tendinopathy of the first dorsal extensor compartment of the wrist, causing radial-sided wrist pain. One hundred patients were enrolled and allocated to either corticosteroid injection (CSI; n=49) or open surgical release (n=51). The CSI protocol consisted of triamcinolone acetonide (40mg/mL, 1mL) combined with 1% lidocaine (1mL) injected into the first dorsal compartment under aseptic conditions. Surgical release involved longitudinal decompression of the fibro-osseous sheath overlying the APL and EPB tendons. The primary outcome was VAS pain score at baseline, one month, and six months. Statistical analysis included independent t-tests and linear mixed-effects modeling.

Inclusion Criteria:

• Clinical diagnosis of De Quervain tenosynovitis confirmed by positive Finkelstein test
• Age 18-70 years
• Pain sufficiently severe to impair activities of daily living
• Failure to respond to at least 4 weeks of conservative management

Exclusion Criteria:

• Concurrent inflammatory arthropathy (rheumatoid arthritis or gout)
• History of prior wrist injury
• Previous surgical or injection treatment for De Quervain tenosynovitis
• Coexisting upper limb pathology (rotator cuff pathology, epicondylitis, or carpal tunnel syndrome)

Individual participant data are not publicly available due to institutional privacy policies but are available from the corresponding author upon reasonable request.

VAS assessments at follow-up were performed by a trained assessor blinded to treatment allocation.