The Finkelstein Test assesses whether a controlled thumb and wrist manoeuvre reproduces familiar radial wrist pain near the first dorsal compartment. It is commonly used in suspected de Quervain’s tenosynovitis. Current clinical discussion highlights that Finkelstein and Eichhoff-style tests are often confused and can be painful even in people without tendon inflammation, so interpretation should be cautious and based on familiar symptom reproduction, location and related findings.
A client reports pain at the radial side of the wrist when lifting a child, gripping a dumbbell, opening jars, using a phone or moving the thumb. The pain is near the radial styloid and may worsen with thumb motion.
The Finkelstein Test can help assess whether controlled loading of the first dorsal compartment reproduces familiar pain. It should not be performed aggressively, and it should not be used alone to diagnose de Quervain’s tenosynovitis.
Test name: Finkelstein Test
Body region: Radial wrist, thumb, first dorsal compartment
Purpose: Assess radial wrist pain response linked to abductor pollicis longus and extensor pollicis brevis region
Positive finding: Familiar pain over the radial styloid or first dorsal compartment
Negative finding: No familiar radial wrist pain
Best used with: Palpation, resisted thumb extension/abduction, wrist ROM, grip tasks and functional history
Key limitation: Stand-alone diagnostic accuracy evidence is limited and test variations are often confused
The Finkelstein Test is a radial wrist pain provocation test used in suspected de Quervain’s tenosynovitis. A commonly described version involves the examiner guiding the thumb and wrist into a position that tensions the first dorsal compartment.
Many clinical settings incorrectly label the Eichhoff manoeuvre as Finkelstein’s test. In an Eichhoff-style test, the client places the thumb inside the fist and ulnarly deviates the wrist. This can be more provocative and less specific.
The test is used when de Quervain’s tenosynovitis or first dorsal compartment irritation is part of the assessment reasoning.
It may be relevant in clients with radial wrist pain during gripping, lifting, thumb use, childcare, racquet sport, gym training, phone use or repetitive wrist/thumb tasks.
It assesses radial wrist pain response to tensioning or loading of the thumb tendons around the first dorsal compartment. It does not directly visualise tenosynovitis or confirm the diagnosis.
Radial wrist pain may also come from thumb CMC joint pain, scaphoid injury, superficial radial nerve irritation, intersection syndrome or other wrist conditions.
This test may be useful for clients with radial wrist pain, thumb movement pain, gripping pain, postpartum or childcare-related wrist pain, occupational overuse symptoms or gym-related thumb/wrist symptoms.
Use when radial wrist pain is present and a controlled first dorsal compartment provocation test is appropriate.
Use caution with acute wrist trauma, suspected fracture, severe pain, major swelling, recent surgery, marked hypersensitivity or suspected scaphoid injury.
Do not force ulnar deviation or thumb flexion.
Pain scale
Measurz recording workflow
Optional comparison-side notes
Optional grip or pinch strength tools
Position the client sitting with the forearm supported and wrist relaxed.
The wrist and thumb are relaxed.
Sit or stand beside the tested wrist.
Support the forearm and guide the thumb and wrist carefully.
Avoid forcing the thumb or wrist into painful end range.
Use a controlled Finkelstein-style manoeuvre to tension the first dorsal compartment. If using an Eichhoff-style version, record it clearly as that variation.
Ask the client to report pain location, intensity and whether symptoms match their usual radial wrist pain.
A positive finding is reproduction of familiar pain over the radial styloid or first dorsal compartment.
A negative finding is no familiar radial wrist pain during the manoeuvre.
Stop if pain increases sharply, symptoms spread, the client guards strongly or the test is not tolerated.
Use a gentle approach. Record the exact variation used.
A positive Finkelstein Test may increase suspicion of de Quervain’s tenosynovitis when it reproduces familiar pain over the first dorsal compartment and aligns with history, palpation and thumb-loading symptoms.
A positive test does not confirm de Quervain’s. Similar pain may occur with thumb CMC joint irritation, superficial radial nerve sensitivity, intersection syndrome or scaphoid/radial wrist pathology.
A negative test reduces suspicion under the tested conditions but does not fully exclude de Quervain’s, especially if symptoms occur only during higher-load gripping or repetitive tasks.
At the time of writing, strong 2020+ peer-reviewed diagnostic accuracy values for the stand-alone Finkelstein Test appear limited.
Condition or presentation: suspected de Quervain’s tenosynovitis
Population: people with radial wrist pain or suspected first dorsal compartment symptoms
Test variation: Finkelstein Test, often confused with Eichhoff-style manoeuvres
Reference standard: not consistently established across current literature
Sensitivity: not clearly established in high-quality current evidence
Specificity: not clearly established in high-quality current evidence
Positive likelihood ratio: not available
Negative likelihood ratio: not available
Key limitations: variation in how the test is performed, confusion with Eichhoff’s test, possible pain in asymptomatic people, and overlap with other radial wrist conditions
A 2020 paper on de Quervain’s tests noted that standard tests, including Finkelstein and Eichhoff-style tests, can be painful and proposed more patient-friendly alternatives.
Reliability depends on using the same test variation, force, wrist position, thumb position, pain criteria and comparison side.
Validity is limited when the test variation is not recorded, because Finkelstein and Eichhoff manoeuvres are often used interchangeably in practice.
Common errors include using an Eichhoff manoeuvre but calling it Finkelstein, forcing the wrist into ulnar deviation, not recording pain location, ignoring thumb CMC pain and treating any radial wrist pain as de Quervain’s.
Limitations include pain provocation in non-de Quervain presentations, variable protocols and limited stand-alone diagnostic accuracy evidence.
Use the Finkelstein Test to document whether controlled first dorsal compartment provocation reproduces familiar radial wrist pain. Pair it with palpation, thumb strength, grip tasks and functional history.
Record test name, side tested, variation used, result, pain score, pain location, symptom quality, thumb position, wrist position, force level, comparison side, irritability, confidence in result and reason for stopping.
Add related findings such as palpation over first dorsal compartment, resisted thumb extension/abduction, grip or pinch symptoms, thumb CMC findings and functional task triggers.
Phalen’s Test
Wrist Tinel’s Test
Allen Test
Scaphoid Shift Test
Grip Strength Test
Thumb ROM Tests
Wrist ROM Tests
Upper Limb Tension Tests
It assesses whether a thumb and wrist manoeuvre reproduces familiar radial wrist pain near the first dorsal compartment.
A positive finding is familiar pain over the radial styloid or first dorsal compartment.
No. They are often confused, so the exact variation should be recorded.
No. It may support suspicion but does not confirm the diagnosis on its own.
Record the variation used, side, pain score, pain location, thumb and wrist position, comparison side and related findings.
Finkelstein Test assesses radial wrist pain around the first dorsal compartment.
The exact variation must be recorded.
A positive test does not confirm de Quervain’s on its own.
Use a gentle approach to avoid unnecessary pain provocation.
Measurz should capture variation, symptoms, position and comparison side.
Lahiri, A., & colleagues. (2020). Simple and patient-friendly clinical diagnostic tests for de Quervain’s disease. Journal/source details need verification.
Hand Therapy Academy. (2024). Understanding de Quervain’s pathology: A comprehensive exploration of special tests.
