DeQuervains tenosynovitis presents as pain over the top of the thumb and into the thumb side of the wrist, which can become swollen and tender to touch. It can be painful to move the thumb and can make it difficult to hold and pinch items, as well as cradle your baby’s head in your palm.
This condition is a type of overuse problem and commonly presents in caregivers of small children from lifting their baby and performing tasks with the thumb and fingertips, such as applying nappies and pegging clothes. It has been referred to as mommy’s thumb. Other unrelated causes can be gardening and painting.
There is inflammation of the tendons that lift the thumb up (extensor pollicis brevis) and take the thumb out to the side (abductor pollicis longus), and also the tunnel (sheath) they pass through at your wrist. Often a bump or swelling occurs over the bony part on the thumb side of the wrist.
A hand therapist will provide an assessment and diagnosis, and it can be confirmed by ultrasound if required. It does not often resolve quickly on it’s own, so it is best to present early for treatment of the problem. Very severe or long term cases may opt for a cortisone injection combined with hand therapy, or surgery.
Splint/Orthosis:
Your hand therapist will custom make you an orthosis/splint which will be worn most of the time for a number of weeks to allow adequate rest of the tendons. Your hand therapist will assist in choosing the best splinting option for you and your baby. This orthosis can be removed for showering, hand washing and exercises. It can get wet and be cleaned easily.
You may have bought a brace from the chemist or been provided with an off the shelf splint, but these often don’t provide support in the right places for this condition. A custom made orthosis will hold the wrist and thumb in the best position for healing.
Hand Therapy:
To reduce swelling, your hand therapist may suggest applying cool compresses to your wrist and thumb, and provide ultrasound therapy or gentle massage.
Exercises:
Prevention of stiffness in your wrist and thumb will be treated with an exercise program prescribed by your hand therapist, including movement and gentle stretches.
As you improve, your hand therapist will provide you with strengthening exercises to ensure your body is able to handle the challenge as your baby grows.
Activity:
Resting your thumb, hand and wrist will assist to settle the inflammation. However, as a Mum, this is often asking too much! Changing the way you perform tasks for your baby will give you relief and allow you to continue to care for your baby.
Your hand therapist can provide advice on your position and posture when you are performing certain tasks with your baby, including carrying, nursing and the never ending laundry!
Goal of hand therapy:
The main goal of hand therapy is to settle the inflammation and pain in your thumb tendons to allow you to lift, carry and hold your baby safely.
If you have symptoms of Mother’s thumb, contact Belinda today to discuss your orthosis, exercise program and advice to get you back to your best for you and your family.
