Postnatal Wrist and Thumb Pain

By Adelaide Women's Physio | March 17, 2017

It can be common for new mums with young babes to experience wrist pain on its own, or it can be combined with thumb pain.  This condition is often more frequent with first time mums. It is referred to as de Quervain’s tenosynovitis. Some mothers may also experience wrist pain with pins and needles and numbness in the palm or fingers. This is referred to as carpal tunnel syndrome (CTS). Assessment by a Physiotherapist or Doctor will assist in deciding the correct diagnosis of your presentation.

There are a number of reasons for why your wrist pain can occur postnatally. These will now be discussed.

  • The pregnancy softening hormones are still present in a mother’ tissues for around 4 to 6 months after delivery. Softened tissues are more likely to be injured when repetitive loads are placed on them.
  • Fluid retention and fluid balance changes can be present after the delivery, where tissue inflammation in the area of strained tendons can be felt as pain. This occurs because the tendons are unable to glide smoothly in their tendon coverings or soft tissue tunnel.
  • New mums are suddenly required to lift and hold their baby frequently and for long periods during the day and night. Repeated and sustained wrist/ thumb postures combined with loading (baby’s weight), places strain on tendons, muscles, ligaments or nerves at the wrist, thumb and forearm.
  • Fatigue from diminished and poor quality sleep adds to the problem, with a mother often not being in the right headspace to think about herself and her posture. Baby care dominates her thinking at all times.

Strategies for resolving wrist pain:

  • Take action early when your wrist pain symptoms are mild, by finding a physiotherapist working with pregnant and post-natal women
  • Do not put up with moments of wrist pain in daily activity thinking this will get better
  • Be prepared to change how you are holding, feeding and handling your baby along with daily activities and housework
  • Be aware of using a more neutral wrist position when feeding and caring for your baby, less strain is then placed on sore wrist and thumb tendons
  • Support the weight of baby’s head on your forearm, not with your hand
  • Learn to use pillows and your arm when holding baby

Resting the inflamed tendons is an important part of healing. This can mean wearing an appropriate wrist/thumb splint that is fitted by your physiotherapist.

  • Ask for and accept help in daily activities such as food preparation (chopping vegetables) and housework
  • Self-massage of forearm, thumb and palm muscles, and the application of ice/heat can be soothing
  • Strengthening and stretching exercises for wrist, thumb, finger, forearm, upper arm and shoulder muscles are important to develop general arm and hand conditioning

These exercises are best selected by a skilled health professional who takes into account the individuals symptoms and assessment findings.

Careful progression of the exercises is necessary to gain the arm and hand strength required to handle a constantly increasing, moving weight (baby).