Mummy’s Thumb

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If lifting your baby is making your hand hurt you may be suffering from Quervain’s Tenosynovitis, more commonly referred to as ‘Mummy Thumb’.

Mummy's Thumb - suffering from Quervain’s Tenosynovitis

What is De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is a painful inflammation of the tendons located on the thumb side of your wrist. It is caused by repetitive strain or overuse of the wrist or thumb.

The condition is also known as ‘Mummy Thumb’, as it is commonly seen in new mothers as a result of repetitive lifting or holding a baby.

How does it occur?

De Quervain’s usually occurs from overusing your thumb or wrist, especially movements such as gripping, grasping, clenching, pinching, or wringing.

The most common cause of “Mummy Thumb” is repetitive motion of placing the thumb and index finger in the shape of an “L” to lift and hold young children. Lifting a child from a lower position (eg. from the ground or a low crib) further increases the risk of the condition. Hormonal changes associated with nursing and pregnancy may also contribute to tendon swelling and weaker thumb and wrist function.

Additionally, there are a variety of other activities that may cause or exacerbate De Quervain’s, including:

  • Gardening
  • Playing a musical instrument
  • Knitting
  • Computer use (eg. Typing)
  • Texting and scrolling (think Facebook) is the top of the ‘other causes’ list. This is key with new mums as they are frequently stuck at home so often text and check Facebook a lot.

What are the symptoms?

Symptoms may include:

  • Pain over the wrist and at the base of the thumb that is made worse by acitivity and eased by rest.
  • Pain may radiate to the forearm.
  • Swelling and tenderness over the base of the thumb.
  • Difficulty moving the thumb into a splayed position or pain with gripping, pinching, or when making a fist
  • A grating sensation during certain movements

When should I see a doctor?

See a doctor as soon as the pain is affecting your daily activities. The condition is best caught before it gets too severe. The earlier you learn behaviour modifications, such as how to lift your baby correctly, the less likelihood of persistent or prolonged pain and disability.

A doctor will examine the affected area and may arrange a physiotherapy referral.

How is it diagnosed?

The diagnosis of De Quervain’s will be made after examination of the affected area by a doctor. Tests are usually not required. An X-ray or ultrasound scan of the area may be needed only if the diagnosis is uncertain or to exclude something more serious (eg. Fracture).

What is the treatment?

Initial treatments should include:

  • Avoidance and rest – avoiding the offending activity or modification of aggravating thumb and wrist movements to allow the condition to settle. Your doctor or physiotherapist can help suggest alternative ways of lifting and carrying babies etc
  • Ice packs – placing an ice pack on your thumb or wrist may ease swelling and pain. Applying it the affected area for 10-20 minutes twice a day may reduce pain.
  • Anti-inflammatory painkillers – these are often prescribed to reduce inflammation and provide pain relief.
  • If the condition is not improving, physiotherapy may be recommended.
  • A physiotherapist can provide rehabilitation exercises that can help speed up recovery and prevent recurrence.
  • Sometimes a thumb splint, firm bandage, or brace may be used. This may provide immediate relief that forcing the thumb and wrist to stay in the same position for some time. This will limit movement of the thumb and allow rest of the affected tendon.
  • In resistance cases, the following measures may be tried:
  • Corticosteroid injection – a steroid injection into the area around tendon is often very effective in easing pain. However, these effects are often short-lived and the pain may recur, as it does not treat the underlying problem.
  • Surgery – surgical release of the tendon is rarely needed. It can be considered for those who fail to respond to steroid injections.

What is the outlook?

Recovery depends on many factors. A mild injury may recover within a few weeks, whereas a severe injury may take six weeks or longer to recover.

Can De Quervain’s be prevented?

There is no clear evidence that anything can prevent De Quervain’s tenosynovitis. However, we encourage you to consult a doctor or physiotherapist about the correct ways to look after and hold your baby. Also, the following are suggestions that may help prevent its recurrence:

  • Avoid a sudden increase in repetitive movements of the thumb or wrist.
  • Exercises to strengthen the muscles around the affected tendon may help. It may be best to seek advice from a physiotherapist to find the best exercises to use.
  • Education on movements and positions to avoid and eliminate repetitive strain.
  • Take regular short breaks from long or intense, repetitive activity.

References

Careuk.com. (2012). De Quervain’s Tenosynovitis Health Information Factsheet. [online] Available at: http://www.careuk.com/sites/default/files/Patient_Leaflet_DeQuervains.pdf [Accessed 10 Sep. 2018].

Lee, J. (2011). “Mommy Thumb” | Wrist and Thumb Pain | DeQuervain’s Tendonitis Singapore – Dr. Jonathan Lee Yi-Liang. [online] Dr. Jonathan Lee Yi-Liang. Available at: http://www.handsurgery.com.sg/wordpress/?p=369

Payne, J. (2016). Tendinopathy and Tenosynovitis (Tendinosis) | Causes and Treatment. [online] Patient.info. Available at: https://patient.info/health/tendinopathy-and-tenosynovitis-tendinosis

Smith, R. (2013). The upper limb in primary care Part 2: Wrist, hand. Hands On Arthritis Research UK, 2(7).

Written by Central Health Medical Practice

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