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Mommy Thumb (de Quervian Tenosynovitis)

de Quervain tenosynovitis is a common cause of hand or wrist pain in adults.  It is sometimes called “mommy’s thumb” or “mommy’s wrist” because it seems to be more common in women especially during the newborn period.  It seems to present itself in the first 4 to 6 weeks after delivery. I had “mommy thumb” during my first month postpartum with Madi, it hurt!

What is “Mommy’s Thumb”?

It is called “mommy’s thumb” because the pain and discomfort usually affects the base of the thumb where it connects to the wrist.  The pain is occurs most often with thumb movement that spreads down to the forearm. Sometimes there is swelling and tenderness.  It can affect both sides, but often is worse on one side than the other.  

It isn’t inflammation that causes the pain and discomfort.  Rather it is overuse and repetitive movements that cause the pain.  

New moms are at higher risk because of the repetitive movements of lifting and holding newborns.  Breastfeeding can also contribute due to the positioning of the hand and wrist for holding the newborn to the breast.  Hormones and fluid retention may also be contributing factors.  

Will The Pain Ever Go Away?

The good news is that de Quervain’s tenosynovitis is generally self-limiting.  This means that it will generally resolve on its own, usually within a year.  

In breastfeeding women who experience pain when positioning their infant, the pain usually subsides after they stop nursing.  

Treatment of “Mommy’s Thumb”

Otherwise, in the meantime, the main goal is to relieve symptoms.  Analgesics like NSAIDs and applying ice packs to the affected area may help.  

Your doctor may advise splinting the affected side.  Most people find that pain subsides when they wear the splint, but it returns when the splint is removed.  

If splinting and pain medicine doesn’t help, your doctor may also suggest a glucocorticoid injection.  A steroid medication is injected into the tendon on the affected side.  This can be very effective and long lasting pain relief.  There are few side effects with this treatment.  

Surgery is generally not indicated for “mommy’s thumb” since it usually goes away on its own.  

This post was co-authored by Erin Manchuk, BScPharm, BCGP and Stephanie Liu, MD, MSc, CCFP, BHSc.

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