“Mum’s thumb”, also known as De Quervain’s Tenosynovitis, is a painful condition that is commonly experienced by new mums when looking after their babies.
At the Bodywell clinic, we see a lot of new mums struggling with this condition, and we understand the significant impact that it can have on your life and your ability to care for your newborn.
Read on to find out about the symptoms of mum’s thumb, it’s causes, and what you can do TODAY to begin feeling better.
What is Mum’s thumb?
Mums who are suffering with DeQuervain’s Tenosynovitis often describe a sharp pain felt at the base of the thumb and wrist, which can often shoot into the hand or forearm. This may be felt on one side only, or on both sides.
Other symptoms can include a clicking, grabbing, or catching sensation in the thumb and wrist.
You might notice that these symptoms occur when doing activities that place strain on the thumb or wrist such as picking up your baby, changing their clothes or nappies, or when trying to grasp or grip items.
Figure 1- De Quervain tenosynovitis tendons
(Mayo Foundation for Medical Education and Research)
What causes Mum’s thumb?
Although DeQuervain’s can be associated with direct injury to the wrist such as a fall, the most common reason for this condition is due to overuse of the muscles in the thumb and wrist.
Repetitive use of the muscles in the thumb and wrist leads to irritation, swelling, and inflammation of the tendons. This swelling prevents the tendons from freely gliding through a sheath (tunnel) at the base of the thumb, which limits movement and contributes to pain as well as the symptoms of catching or grabbing.
The reason this condition is so common with new mums is due to the repetitive tasks that are performed numerous times on a daily basis – changing nappies, feeding baby, picking up and holding baby for a length of time, and bathing baby, to name a few.
The other reason that new mums are at a higher risk of developing this condition is due to changes that occur during pregnancy and into the post-partum stage, such as looser ligaments and increased swelling/fluid retention.
How to get relief from Mum’s Thumb
The key to treating De Quervain’s is to reduce the inflammation and swelling, and minimise strain on the tendons and muscles. Here are some practical tips that you can do to achieve these goals.
Ice and heat
- Alternating between ice and heat on the area throughout the day can help reduce the amount of swelling and assist in managing your pain.
- Alternate between hot and cold every 4-5 minutes, for a total of 20 minutes. You should aim to do this 2-3 times a day.
Rest and modified movement
- Resting the affected hand as much as possible and limiting aggravating movements – ask family members for assistance whenever feasible.
- When lifting your baby, try to keep your thumb tucked in next to your index finger rather than extended away from the hand.
Anti-inflammatory creams, gels, and tablets
- Rubbing an anti-inflammatory cream or gel into the affected area around the thumb and wrist 2-3 times a day may provide an improvement in your pain levels.
- Most over the counter anti-inflammatory creams & gels are generally safe to use sparingly when breastfeeding, however please make sure to check with your healthcare professional.
- Alternatively, you may get some relief with taking over the counter anti-inflammatory medications like aspirin and ibuprofen (these should be taken only under the guidance of your GP or pharmacist, especially if you are breastfeeding.)
- You should not use creams and take anti-inflammatory medications at the same time unless advised otherwise by your doctor.
Splinting and taping
- Application of a supportive tape over the wrist and thumb to reduce strain on the joints and tendons can offer some relief. You can purchase this tape from most pharmacies, and have your partner apply it as shown in this short video.
- Alternatively, a thumb splint can also be purchased from pharmacies. The use of a splint will limit movement of the joints and tendons to reduce overuse, and assist in the healing process.
Osteopathic treatment and rehabilitation exercises
- Osteopathic treatment aims to reduce strain on the thumb and wrist tendons, and assist with reducing inflammation and swelling
- Your osteopath may perform massage and stretching techniques to the muscles around the wrist and hand and gentle mobility techniques to increase range of motion
- Whilst some techniques may be performed directly to the site of pain, your osteopath may also treat adjacent regions such as the elbow and shoulder
Some osteopaths may also use dry needling therapy to assist in managing DeQuervain’s symptoms - Your osteopath will also provide you with a tailored rehabilitation program to strengthen your wrist and thumb tendons. In the meantime, below are some exercises that you can try at home today. (Please stop if the exercise causes aggravation of your symptoms)
Corticosteroid injection
- If the combination of the above management strategies is not providing you with significant improvement of your pain, your GP may refer you to have a cortisone injection in the site of the pain, which is typically done via the guidance of an ultrasound.
Non- conservative treatment: surgery
- If all the conservative options including cortisone injection have been tried, and are providing little impact on your pain, then surgery is typically a last resort option.
- Surgery for Dequervain’s increases the space available for the tendons to glide freely. This typically involves a small incision at the base of the thumb and then a cut to open the top of the sheath that covers the tendons.
Where to go from here?
If you have any questions or concerns regarding mum’s thumb, please get in touch with our team of trained osteopaths who can give you further advice and recommendations to help reduce your pain.
Ph: 9717 1200
E: info@bodywellhealthcare.com.au
Brukner P, Khan K. 2007. Clinical Sports Medicine (3rd Ed). McGraw-Hill, Sydney
Goel R, Abzug JM. de Quervain’s tenosynovitis: a review of the rehabilitative options. Hand (N Y). 2015;10(1):1-5. doi:10.1007/s11552-014-9649-3
https://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/symptoms-causes/syc-20371332
Figure 1- Mayo Foundation for Medical Education and Research (MFMER), De Quervain tenosynovitis tendons, accessed 31 August 2020, <https://www.mayoclinic.org/diseases-conditions/de-quervains-tenosynovitis/symptoms-causes/syc-20371332>