This condition appears to afflict new mothers most, but anyone who constantly manoeuvres his hands and wrists improperly when lifting or gripping is at risk of developing the problem.
Do you experience painful clicking or popping every time you lift your tot or wring your wet clothes? That could be a possible sign of De Quervain’s Tenosynovitis. Widely seen in females aged between 30 and 50, Mommy Thumb, as the condition is more commonly known, is most prevalent among new mothers, especially those with heavy babies — their pain is due to them constantly lifting their baby with their thumb extended, their wrist bent and their fingers wrapped around the child’s back, straining the tendons below the thumb. Water retention during pregnancy and breastfeeding after delivery may precipitate the condition or make it worse.
While lifting babies and wringing clothes are rather women-centric chores, men are not exempt from getting Mommy Thumb. In fact, anyone who constantly manoeuvres his hands and wrists improperly when lifting or gripping is at risk of developing the problem. Other activities that can cause it include gardening, carpentry, typing on a keyboard, holding a tablet during prolonged usage, cooking and knitting. The condition is also seen in tennis players and musicians. Patients will experience severe, sharp and shooting pain when moving the thumb, and when twisting the wrist. A painful, tender swelling can develop at the base of the thumb or the side of the wrist.
When treatment is delayed, the pain can travel up the forearm, or down to the thumb and limit its movement. Notably, pregnant women, or those suffering from diabetes and rheumatoid arthritis, stand a higher chance of getting it.
“Hand injury is common because we use our hands for everything,” says hand surgeon Dr Tan Soo Heong. Picking up and holding a baby can seem like the most normal thing to do for mothers, but overstrain of the thumb and wrist from continuous, repetitive movements can lead to problems later on. Bending over to hold and carry your child causes the tendons located in the wrists and thumbs to be extremely strained. These tendons run from the forearm to the thumb and would normally glide easily through a tunnel located at the base of the thumb. But strained injury of the tendons leads to inflammation that can cause the tunnel to narrow, giving rise to swelling, friction and pain.
When it comes to treatment, Dr Tan highlights that relieving the pain and swelling in the thumb and wrist, and restoring their normal functions, will be the primary goals. Hand movements will have to be limited to avoid further trauma and to allow the tendons sufficient time to rest and repair. This can be done by wearing a brace to immobilise the area. Medications to reduce inflammation and pain can be given. Steroids injections are helpful, especially when the pain is severe. In long-standing or severe cases, surgery will be necessary.
In addition, Dr Tan also recommends steps that one could take at home to relieve mild symptoms. These include:
- Limit activities in the affected hand and wrist; avoid activities that cause pain
- Use a splint to immobilise the wrist and thumb
- Modify the way you carry your baby or when breastfeeding
- Apply a hot or cold compress on the affected area a few times a day
In early and mild conditions, symptoms often improve in a few weeks with self-care. Consult a doctor if the pain persists or if you experience severe pain. Patients may also start incorporating some gentle stretches once the symptoms ease, preferably under the guidance of a hand therapist.