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De Quervain’s tendinitis occurs when the tendons around the base of your thumb become irritated. The irritation causes swelling and pain along the thumb side of your wrist. You have probably noticed the pain most when forming a fist, grasping objects, when turning your wrist or picking up your child, feeding your baby, or putting your seat belt on. It can be a sharp grabbing pain at the base of the thumb, or a dull aching feeling - or you might experience both types of pain.
Two of the main tendons that move your thumb pass through a compartment in your wrist area. When the tendons become inflamed the lining around the tendon (the synovium) swells and changes the shape of the compartment. The change of shape makes it difficult for the tendons to pass through the compartment. Changing nappies, holding the baby to feed or settle, lifting in and out of the cot, and all the wonderful things we do when we have a new baby, can put extra strain on the the thumbs and wrists.
Why do I have De Quervain’s Tendinitis?
De Quervain’s Tendinitis is very common in mothers. It can occur while you are pregnant due to an imbalance of the lubricating fluid around the tendon or an increase in fluid around the wrist and hands during pregnancy. This is usually due to a change in hormones. Other women will notice De Quervain’s pain after caring for their newborn baby for a few months or when their child is around 12 months of age. In this instance, De Quervain’s occurs as a result of picking up or carrying your baby repetitively. Hard to avoid!
How is De Quervain’s Tendinitis treated?
There are 3 main ways of treating De Quervain’s:
Immobilisation and activity modification
Steroid injection
Surgery
Hand therapy will be an important part of your recovery with any type of treatment. Complete immobilisation of the thumb and wrist in a splint is usually trialled - we know this can be hard when you are parenting a baby, so we have developed some other splinting ideas and taping methods that can assist.
Most mothers find that their symptoms improve with a combination of hand therapy and activity modification until their child is able to do more for themselves.
What will hand therapy involve?
Your therapist will provide you with important education and information about managing your injury pre and post operatively.
Hand therapy will include:
Static thumb splinting to immobilise and protect your thumb. If static splinting is not an option due to child care then hand therapy can offer alternative soft splinting options.
Oedema management (reducing any swelling in the areas)
Exercise program
Guided return to full functional use
Advice on activity modification to reduce the aggravation to the tendons
How can I modify activities myself at home?
Avoid lifting your child with your thumbs outstretched. Still lift them! But, try to work out a way where you are not bending your wrist in awkward positions and attempt to have your thumbs in close by your hand if you can safely lift your baby whilst doing so.
Try to use the crook of your elbow to support your child instead of your palm
Avoid activities that cause pain to increase e.g.: turning door knobs, taps, wringing out washing (you could try using your other hand to start with).