“Mommy thumb,” medically known as De Quervain’s tenosynovitis, is a condition that can cause pain at the base of the thumb and along the wrist. It commonly affects new parents and caregivers due to the repetitive hand and wrist movements involved in infant care. This condition is generally treatable and manageable, offering relief to those experiencing its symptoms.
Understanding Mommy Thumb
Mommy thumb occurs when the tendons on the thumb side of the wrist become inflamed and swollen. Specifically, it affects two tendons, the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB), which help move the thumb away from the hand and straighten its joints. These tendons typically glide smoothly through a protective tunnel, or sheath, at the wrist. However, repetitive motions can cause this sheath to swell or thicken, creating friction and pain with movement.
Symptoms include pain, tenderness, and swelling along the thumb side of the wrist, which can sometimes extend up the forearm. Difficulty grasping objects, making a fist, or pinching may occur. A catching or snapping sensation can also occur when moving the thumb. Pain worsens with activities involving twisting the wrist or forcefully gripping objects, such as lifting a child. New parents often develop this condition approximately four to six weeks postpartum due to lifting, holding, feeding, and texting associated with infant care.
Treatment Approaches
Addressing mommy thumb typically begins with conservative strategies aimed at reducing inflammation and pain. Resting the affected hand and avoiding aggravating activities are first steps. Applying ice packs to the wrist for 10-20 minutes several times a day reduces swelling and discomfort. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, also alleviate pain and inflammation.
Immobilizing the thumb and wrist with a splint or brace, such as a thumb spica splint, can provide significant relief by resting irritated tendons. These splints are worn for several weeks, allowing tendons to heal. Gentle stretching and exercises are recommended as pain subsides to improve range of motion and tendon gliding. However, consult a physical therapist or healthcare provider before starting any exercise regimen to ensure proper technique and avoid further irritation.
If conservative measures do not provide sufficient relief, a healthcare provider may suggest medical interventions. Corticosteroid injections directly into the tendon sheath can significantly reduce inflammation and pain, often providing relief within weeks. While effective, these injections carry a small risk of side effects, such as temporary pain flare-ups or, rarely, skin thinning. If severe symptoms persist despite non-surgical treatments, De Quervain’s release surgery is considered. This outpatient procedure involves opening the constricted tendon sheath to create more space for the tendons, relieving pressure and allowing them to glide freely.
Prevention and Management Strategies
To prevent recurrence or manage mommy thumb, especially for new parents, modifying daily routines and postures helps. When lifting a baby, avoid using an “L” shape with the thumb and index finger, placing stress on wrist tendons. Instead, scoop the baby using forearms and arms, keeping wrists straight and close to the body to distribute weight evenly.
Adjusting feeding positions and using support tools reduces strain. Utilizing nursing pillows or baby carriers supports the baby’s weight, allowing hands and wrists to relax. Varying holding positions throughout the day, such as a football or straddle hold, prevents overuse of specific muscles and tendons. Taking frequent short breaks from repetitive tasks, like prolonged phone use or holding a baby, rests the hands and wrists.
Once pain has subsided, incorporating strengthening exercises for forearm and wrist muscles enhances long-term stability and resilience. Exercises like wrist flexions, extensions, and radial deviations, often performed with light weights or resistance bands, build strength. Exercises that strengthen the thumb’s ability to move away from the fingers, such as thumb lifts or resistance stretches, are beneficial. Maintaining awareness of activities that trigger pain and actively modifying them is an ongoing strategy for managing mommy thumb.