Mother's Thumb: How to Ease Wrist Pain After Pregnancy
If you're like most new moms, you spend a fair amount of time—OK, a lot of time—picking up and holding your baby. And while this is undoubtedly good for Junior, it may be taking a toll on your body, specifically your wrists.
De Quervain's tenosynovitis – also known as mother's thumb – is a condition in which the tendons from the thumb to the wrist become inflamed and rub against the "tunnel" that encloses them, causing sensations from mild discomfort to severe pain on the thumb side of the wrist.
Though anyone can develop de Quervain's, it's most common in new mothers and usually stems from stress on the wrist resulting from lifting a baby frequently. A 2009 study from the University of Colorado found that women are four times more likely to develop de Quervain's than men. Michelle G. Carlson, M.D., an orthopedic surgeon specializing in hand and upper extremities at New York's Hospital for Special Surgery, estimates that the ratio is even higher. "I'd say it's about 90 percent new moms," she says.
Causes of Mother’s Thumb
According to Louis W. Catalano III, M.D., an orthopedic surgeon at Roosevelt Hospital's C.V. Starr Hand Surgery Center in New York, if you've recently given birth and are experiencing wrist pain, particularly when moving your thumbs or lifting your baby, you're most likely suffering from de Quervain's tendonitis.
While Catalano says several factors likely contribute—including extra weight and fluid retention from pregnancy, plus hormonal fluctuations—it's the constant lifting that is probably the biggest culprit. "The most important factor is the repetitive lifting of a baby with your wrists sagging toward the ground," he says. Catalano explains that two tendons on the side of the wrist are responsible for moving the thumb. If they become swollen—say, from improper lifting—they can stretch over the the wrist bone, causing pain.
Catalano says the condition can occur at any time, but many women start to have symptoms two to three weeks after childbirth. "DeQuervain's tendonitis is very common," he says. "I see women with the condition at least once a month. It is almost exclusive to women who have recently had a baby, although Catalano says he occasionally sees middle-aged women who have it, as well as stay-at-home dads.
How to Treat Mother's Thumb
It's hard to prevent de Quervain's tenosynovitis because, of course, mothers need to lift their children – sometimes 25 to 30 times per day. And according to David M. Auerbach, M.D., a hand surgeon at the Southern California Orthopedic Institute, "There's no way to tell if you will get it until you have it." Unfortunately, mother's thumb rarely goes away on its own, but doctors agree early recognition and early treatment are key.
Think you've got de Quervain's tenosynovitis? Here are five ways to get a grip on the pain.
1. Lift baby differently.
If you're feeling some discomfort, perhaps the single most important thing you can do to prevent further irritation of the wrist tendons is to modify how you lift your baby, says Dr. Carlson. "Instead of picking your baby up under the arms, try to scoop him up by lifting under his bottom," she advises. "Keep the palm of your hand up." This redistributes pressure that can aggravate the tendons when you lift with your hands in an "L" shape (with your fingers on baby's back and your thumbs on his chest), a position that puts most of the strain on your thumb and wrist.
2. Check your breastfeeding position.
Various nursing positions could put strain on a mother's wrist, especially when inflammation is already present. "Many women cite breastfeeding to be irritating, so if you're nursing, be careful to use a pillow for support so that the full weight of baby's head isn't resting in your hand," Dr. Carlson recommends.
3. Rest your wrist.
Icing your wrist frequently and taking an over-the-counter anti-inflammatory medication can be helpful, according to Dr. Auerbach. (If you're breastfeeding, check with your doctor before taking any medication.) If possible, have your partner do the majority of lifting and carrying baby to give your wrist ample time to heal. Additionally, try to limit smartphone use whenever possible. Sliding, scrolling, and tapping away on your iPhone isn't likely to be the cause of the problem, Dr. Carlson says, but any overuse of those already-inflamed tendons is just going to compound the pain and prevent proper healing.
4. Try a splint.
A spica splint that immobilizes the thumb is extremely effective in helping to reduce swelling of the tendon and therefore easing discomfort, says Dr. Auerbach, "especially if it's used early." Generally, patients will see improvement with splint use after just a couple of weeks, but consistency is key (the immobilization does make everyday tasks more difficult, so it takes commitment to stick it out).
5. See a doctor.
If the pain persists after you've tried a variety of self-treatment remedies, make an appointment with a hand specialist, who may suggest either a cortisone (steroid) shot or physical therapy. In rare, very extreme cases, surgery is necessary but it's usually a permanent fix.