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Mother’s Thumb: What to do about wrist and thumb pain after pregnancy

Sauhin Ng
Our hands connect us with the world; we use them to work, communicate and to care for not only ourselves, but others. With the welcoming of baby into the world comes the endless use of your hands – picking baby up, holding their head while breastfeeding, scooping formula, burping, the list goes on. This unfortunately takes a toll on your body, particularly your wrists. Due to repeated thumb and wrist movement needed while caring for baby and additional factors like hormonal changes and fluid retention, mums are particularly prone to developing a painful condition called De Quervain’s tenosynovitis (also known as Mummy or Mother’s thumb).  

Mother's Thumb


Sauhin Ng is an Occupational Therapist and Practitioner of Hand Therapy who has recently joined the Growlife Medical team with skills specialising in the management of hand, wrist and elbow conditions conditions. In her experience, she regularly sees the impact and frustrations associated with hand and wrist pain. However, conditions such as De Quervain’s which is prevalent in an estimated 50-90% of mothers are too often swept under the rug. 

The condition rarely goes away on its own if not recognised and managed early, but fortunately is easily treated. Sauhin feels strongly about tackling these conditions early to avoid pain taking over your everyday life and longer-term damage that may lead to needing surgery. 

 

In this article, Sauhin explains more about De Quervain’s tenosynovitis (or Mother’s thumb), shares some easy tweaks that can deliver some much-needed relief, and other options out there to treat the pain.



What is De Quervain’s tenosynovitis and why do Mothers so commonly get it? 

It is a painful condition where the protective layering of two tendons that run to the thumb become inflamed or thickened, subsequently impairing the glide of the tendons through a tunnel-like structure on the side of your wrist.


Though anyone can develop the condition, it is often associated with pregnancy, breastfeeding and caring for young children due to the overuse of the thumb and wrist tendons during lifting and feeding. For this reason, it can also affect fathers and grandparents too! It can also occur following forceful, repetitive hand movements such as playing instruments, cutting with scissors, or after an acute injury such as a direct blow or a wrenching force to the wrist and hand like a yanking of a dog lead.  


What are the Symptoms?

  • Pain and swelling at the thumb side of the wrist. Pain can also radiate to the thumb and up the forearm. 
  • Pain when moving the thumb and/or wrist, and when gripping or pinching objects. 
  • Loss of movement of the thumb and/or wrist. 
  • Loss of pinch strength. 
  • A sticky or catching sensation when moving the thumb. 





5 Tips to Manage and Treat De Quervain’s pain

  1. Adjust the way you lift your baby 


The key to reducing pain and preventing further irritation to the wrist tendons is to modify the way you use your hands while caring for your baby. Modifying your lifting technique helps to redistribute the force that aggravates the affected tendons. 

  • Avoid repetitive lifting of baby under their armpits using the ‘L’ shape lift (thumbs on their chest, fingers on their back). 
  • Try and lift from under their bottom using a ‘scooping’ action. 
  • Keep your thumbs tucked in, wrists straight, and palms facing up as you lift them up. You can do this one handed or using your other hand to support behind baby’s head. 
  • Another option is to place your hands either side of their ribcage and gently squeeze to lift. 
  • Consider a drop-side cot. It is important that you ensure all mechanisms are functioning and abide by Australian standards. 
  • If you are reaching down low to pick baby up, get as close to them as possible (rather than using your arms to reach out) and use your entire body to lift including bending of your knees. 




   2.   Consider your nursing position 

Whether you are breastfeeding or using a bottle, nursing positions put significant strain on your wrists that may already be inflamed. 

  • Vary your nursing positions. 
  • Use a nursing pillow to help support baby’s head so your wrist and thumb do not stay in a prolonged awkward position. 
  • Try to keep your thumbs tucked in and wrists as straight as possible. 
  • Sometimes problems with latching can lead to needing to constantly adjust the position of baby’s head while feeding. Consider seeing a lactation consultant for strategies to help with this. 

 



   3.    Rest your wrists 

  • Apply a cold pack to the thumb side of your wrist for 5-10 minutes several times a day. 
  • Limit the use of your smartphone or adjust the way you use it. Avoid using your thumbs to hold the phone and text/swipe. Instead, lean the phone on your palm (thumb tucked in), and use your other pointer finger to text/swipe. 
  • Limit and avoid any activities that aggravate your thumb and wrist pain such as unscrewing bottles, scooping formula. If possible, ask for help with these tasks or talk to a hand therapist for strategies on modifying these tasks. 

 



   4.    See a hand therapist for a custom-fit splint and exercises 

A hand therapist will mould a custom splint to limit your wrist and thumb movement to allow the affected tendons to rest and reduce the inflammation. They will also develop a treatment programme aimed at reducing your pain, enabling you to care for your baby (while caring for your wrist), and gradually strengthening your wrist so you can return to your meaningful activities and avoid re-injury. 




   5.    Talk to your GP 

  • If you are continuing to have pain even after attempts to rest the hand and use a splint, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and/or a cortisone injection in combination with the use of a splint has been shown to have good success in treating this condition. 
  • If symptoms do not resolve over an extended period of time, you may want to discuss surgical interventions with your GP. An orthopaedic or plastic surgeon may consider a compartment release. 


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