By Megan Storey | January 31, 2020
It has been a long journey and you’ve been through a lot over the last 10 months. You’re already exhausted and you’ve only just started your life with a new addition to the family. Life doesn’t get much busier than this, right?! How frustrating then that you’re having to battle through this new period with a sore wrist and thumb. If it’s any consolation, you’re not alone. One study from 2017 reported over 50% of women experienced wrist pain following delivery of their baby, and over 80% of those still had pain two months on. Read on to find out why.
The most common cause of wrist and thumb pain after pregnancy is a condition called De Quervain’s Tenosynovitis. That’s a bit of a mouthful so let us explain simply. There are a few different tendons which run from muscles in the forearm along the thumb side of the wrist, which act to move the thumb away from the hand when the palm is held out flat. The tendons are covered in a thin ‘sheath’ of tissue which provides important lubrication to allow for smooth movement. On their journey from the forearm, the tendons and their sheaths have to pass through a little tunnel, made up of bone and soft tissue. In De Quervain’s, the tendons and/or sheaths become thickened and this leads to problems with movement through the tunnel.
It is thought that new mums are at higher risk of developing this condition due to the repetitive nature of lifting and holding their baby. These movements put the hand, thumb and wrist into a compromised position and increases strain through those tissues. It has also been suggested that increased fluid retention and hormonal changes following pregnancy could also be involved in the development of this condition.
Another common cause of wrist and hand pain following pregnancy is Carpal Tunnel Syndrome. This condition involves the pinching of a nerve as it passes through the wrist. This is different from De Quervain’s in that a patient will experience pins and needles and/or numbness in the hand as well as wrist pain—a blog topic for another month!
Signs and symptoms
If you develop this condition you can expect the following:
- Pain and/or swelling around the base of the thumb, and thumb side of the wrist
- Pain increased by thumb and wrist movements
- Pain associated with gripping, lifting and twisting objects
- Popping/clicking with wrist movements (in severe cases)
If you are reading this and alarm bells are already ringing, then you may want to consider giving us a call to book an appointment. We can help you with this problem so read on to see what treatment we offer.
As this is a busy time of your life, our aim will be to get you out of pain and functioning as soon as possible. After all, you have a little one to prioritise now and it’s not like you can just stop parenting to allow your body to heal. Fortunately, you don’t have to. Our treatment for De Quervain’s may include any or all of the below options:
- Rest and splinting: In the initial stages, you may need to alter how much you do with your wrist and thumb. Getting some extra help around the house from friends and family may help to take the load off. Using feeding pillows to support the baby during meal times is another way to reduce your ‘holding’ time. Wearing a splint or brace can help to reduce aggravating movements in key areas of the wrist whilst still allowing you to move and perform your everyday We may fit you with one of these if we think it is necessary.
- Massage and joint mobilisation: To release tight muscles and restore range of motion to the hand, wrist and forearm joints.
- Taping: To support the wrist or aid with drainage of the wrist area back up the limb towards the heart.
- Stretching: To combat any tightness of the hand and forearm muscles. You’ll also need to do some of these at home.
- Graded strengthening exercises: Evidence is pointing more towards gradual loading exercises to rehabilitate the tendon and restore full movement and strength to the tissues.
Other treatment options include therapeutic ultrasound and corticosteroid injections for pain relief. For severe or persistent cases that don’t respond to a more conservative approach, a surgical opinion may be required. We will always work hard to ensure you don’t reach that point because the recovery is always longer and it means a time period where your function will be much reduced, which is always difficult when you have a little one.
Our advice to you is to not let it get to that in the first place. No matter how trivial you think it is, if you start to feel pain in your wrist in the early days of motherhood, please get in touch with us here at Physiotherapy for Women. We can put all of the above in place straight away to avoid your pain getting out of control. That means more time for you and your baby. What could be more important at this time?
See you next month!