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De Quervain Tenosynovitis

December 3, 2020
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De Quervain's tenosynovitis is an inflammatory condition involving the tendon sheath covering the tendons that are involved in moving the thumb & is a common cause of wrist pain in pregnant and postpartum females. It is sometimes called “mommy’s thumb” or “mommy’s wrist” because it seems to be more common in women especially during the newborn period

 

Book an Appointment with Amruta Nagnoor for Physiotherapy concerns.

CAUSES OF DE QUERVAIN'S TENOSYNOVITIS:

In many cases the cause is unknown. It is more common in women, particularly after pregnancy. Overuse of the tendon, particularly repetitive movements used at work or in a sport, are likely to make the pain & inflammation worse. It can also be brought on by a simple strain

New moms are at higher risk because of the repetitive movements of lifting and holding newborns.  Breastfeeding can also contribute due to the positioning of the hand and wrist for holding the newborn to the breast.  Hormones and fluid retention may also be contributing factors.

 

SIGNS & SYMPTOMS:

The main symptoms are pain & swelling near the base of the thumb.  The pain is occurs most often with thumb movement that spreads down to the forearm. Movements involving the thumb and wrist such as pinching, grasping or wringing make the pain worse. It can affect both sides, but often is worse on one side than the other.   

De Quervain's Tenosynovitis | Upswing Health

HOW TO TREAT MOTHERS 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. 

Think you've got de Quervain's tenosynovitis? Here are five ways to get a grip on the pain.

1. Rest your wrist /Icing

Icing your wrist frequently (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, but any overuse of those already-inflamed tendons is just going to compound the pain and prevent proper healing.

2. Modifying baby lifting/ breastfeeding position.

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. "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.

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" 

4. Splinting.

A spica splint that immobilizes the thumb is extremely effective in helping to reduce swelling of the tendon and therefore easing discomfort. 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). 

Thumb Splint Breathable Thumb Spica Wrist Support Brace for De Quervains  Tenosynovitis Arthritis Tendonitis|brace support|thumb stabilizersplint  brace - AliExpress

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.

In breastfeeding women who experience pain when positioning their infant, the pain usually subsides after they stop nursing.  

6. EXERCISES:

You may do some of these exercises when the initial pain is gone.

  1. Opposition stretch: Rest your hand on a table, palm up. Touch the tip of your thumb to the tip of your little finger. Hold this position for 6 seconds. Repeat 10 times.
  2. Thumb Lifts 1. Place your hand on a flat surface, with your palm up. 2. Lift your thumb away from your palm to make a "C" shape. 3. Hold for about 6 seconds. 4. Repeat 8 to 12 times.
  3. Bend your thumb towards the base of your little finger and move your wrist downwards.

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