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.