“Mummy’s Thumb”:
It is not uncommon to develop wrist and/or thumb pain in pregnancy or as a new mother. One of the most prevalent conditions is de Quervain’s tenosynovitis (also known as “Mummy’s Thumb”).
This condition affects two tendons as they run through a tunnel along the thumb side of your wrist (the Abductor Pollicis Longus and the Extensor Pollicis Brevis). Tendons are structures that connect muscle to bone. These particular tendons extend the thumb outwards and help move the wrist, so that you can grasp something. They may become painful if they are used repetitively or strained.
The hormones associated with pregnancy can relax ligaments in the body (including the wrist), which can make it more susceptible to injury. In addition, the extra pressure caused by fluid retention can also contribute to discomfort, particularly in the extremities.
Symptoms may include:
- Pain (with or without swelling) near the base of the thumb/wrist.
- Pain/difficulty moving the thumb and wrist when doing something that involves grasping, pinching, wringing and/or lifting.
Being a new mother myself, I was surprised by the extra load I noticed in my hands and wrists. Holding the baby for long periods, trying to do everything else one-handed, pushing the pram and managing all the other paraphernalia – it can be hard! It is vital to pay attention to your hand and wrist health to prevent long-term injury.
Some things you may like to consider:
- Try to avoid prolonged, awkward wrist postures, particularly with the wrist bent.
- Try to “scoop” your baby when you pick them up, keeping the wrists neutral (avoid holding beneath the underarms if you can, as this may aggravate your wrist).
- Try using pillows or supports when feeding your baby (always speak with a professional if you are unsure or require assistance with this).
- Try dressing your baby in clothing with zips rather than press studs to avoid excess use of your thumbs.
- Consider a carrier if this is an option for you, so that you can have your baby with you while keeping your hands and wrists free.
- Consider a splint: in some cases, the use of a removable wrist splint (also called a brace or orthosis) can help settle pain by providing rest to the wrist and part of the thumb. A custom-made splint is often best. Hand Therapists (Occupational or Physiotherapists with specialised skills in treatment of the hand and wrist) can provide an assessment as to whether this could assist you and can fabricate one for you, if needed. Taping and exercises can also help.
Other causes of de Quervain’s:
Whilst in many cases, de Quervain’s is a condition experienced by new mothers, it is also possible to develop symptoms from sport, gardening, work, other hobbies and lifestyle factors.
If you are experiencing wrist pain as a result of wrist/hand positioning during breastfeeding, we recommend contacting a Lactation Consultant or the ABA: https://www.breastfeeding.asn.au
If you are experiencing any discomfort in your hands or wrists, I strongly encourage you to seek an individual assessment and management plan with a Hand Therapist. If you’d like to book in for a Hand Therapy appointment at PMPP, please contact reception on 9681 7255 or book online here: https://portmelbournephysio.com.au/book-online-now/
~ Kate Wharton
Occupational Therapist
References:
- Goel, R., & Abzug, J. M. (2015). De Quervain’s Tenosynovitis: A Review of the
Rehabilitative Options. Hand (New York, N.Y.), 10(1), 1–5. http://doi.org/10.1007/s11552-
014-9649-3 - Johnson, Cynda Ann. "Occurrence of de Quervain's disease in postpartum women." Journal of Family Practice, vol. 32, no. 3, Mar. 1991, pp. 325+. Gale Academic OneFile, link.gale.com/apps/doc/A10593651/AONE u=anon~e9ee7338&sid=googleScholar &xid=19d04cfa. Accessed 25 Apr. 2023.
- Skirven, T., Osterman, A., Fedorczyk, J., & Amadio, P. (2011). Rehabilitation of the Hand and Upper Extremity (6 th ed. Vol. 2). Philadelphia, PA: Elsevier Mosby.