Some of the limitations and failure of injection in treatment of De Quervain’s tenosynovitis have been attributed to inaccurate techniques of injection and anatomic variation in the first dorsal compartment. New techniques have been described to enhance the accuracy of injection such as separate injections over the two tendons or injection under ultrasound guidance [12,13]. The liter-ature review determined that side effects of local corti-costeroid injections were relatively mild. However, irritation, change of skin color, skin atrophy, soft tissue calcification, skin defect, hypopigmentation, ecchymosis, and allergic rash were reported [14]. Thus injections have the potential for adverse events, which may make patients indecisive to choose them as a treatment option. These limitations make local steroid injection more challenging to perform. With these realizations, there is an increasing trend for finding new safe modalities for treatment of tendinopathies without emphasis on only anti-inflammatory mechanisms of drugs (NSAIDs or steroids).