Important Message from Park Slope Parents (PSP): Just a reminder, PSP member posts are not checked for accuracy. The content is for general informational purposes only and is not a substitute for medical advice. ParkSlopeParents.com is not intended to, and does not, provide medical advice diagnosis or treatment. Never disregard professional medical advice, or delay in seeking it, because of something you have read on the PSP groups or on the www.parkslopeparents.com website. Never rely on information in an e-mail or on our web site in place of seeking professional medical advice.
Does this sound familiar? A parent shares:
"I seem to have terrible tendonitis in my wrist and thumb. I'm afraid I've stalled on having it looked at and now it's so bad that I can't hold or pick-up my baby (or do much else for that matter) without pain. I have an appointment with a GP but not until December 3rd and I'm getting nervous about functioning over the holiday weekend. I bought a thumb brace that helps a little and have been conscious about the way I position my hands and wrists, but I'm looking for a hand specialist (orthopedist?) who is good and might be able to give me a cortisone shot or something in the next few days. Any tips would be enthusiastically welcomed Thanks!"
Replies:
"I've had c of the thumb -- aka "mommy thumb" -- since July (had baby in May). An unhelpful orthopedic hand surgeon told me to either get a cortisone shot or quit breastfeeding. I didn't do either. I'm currently seeing a hand therapist who massages my wrist and uses ultrasound and electrical stimulation on the area. My right hand is much worse than my left hand; I can't open doors or write with a pen without pain. I'm not sure how much the weekly hand therapy is helping, but I'm hoping it will forestall the need for a cortisone shot. Here's what you can do:
1) Immobilize your wrist and thumb as much as possible. Wear thumb splints that extend to the wrist and wear them even when you sleep.
2) Don't lift anything heavy except the baby, and when lifting the baby, do not bend your wrists and minimize use of your thumb.
3) Ice your thumb joint and wrist area daily.
4) Massage the area to increase blood flow.
5) Wrap your thumb joint and wrist with grip so that even when you can't wear your thumb brace because you need to type, eat, etc., you still have support.
6) Stretch your wrist in both directions. Arms straight, hand flexed (back of your hand faces you) as if you're pushing something away. Then stretch in the other direction (palm faces you)."
"I had pain in both wrists till my son was about 4 months old (funny, I just posted about this in regard to babywearing), exacerbated by my nursing hand position and eventually diagnosed as De Quervain’s tendonitis, a.k.a. De Quervain’s tenosynovitis. Mine fortunately responded to ice and exercise (at home – I never saw a physical therapist or anything), but a cortisone shot would have been the next step and I was told it would be safe while nursing because your body produces steroids naturally, and adding a little extra steroid injected into muscle, not your bloodstream, is a drop in the bucket of your body’s overall natural level. I think doctors don’t always know the answer and err on the side of being conservative; I was seeing a family practitioner (unfortunately, no longer in the city) so she was relatively knowledgeable about breastfeeding compared to a specialist.
Also, I definitely recommend trying exercises; here’s one list that covers most of the ones I did: http://www.summitmedicalgroup.
"I am suffering from the same thing. I saw a specialist that said you can't get the cortisone shot if you are giving the baby breast milk. Not sure if that is your situation. In the meantime I am using the homeopathetic ointment Triflora that I purchased from the coop and it has helped (plus wristguards)."
"I have the same thing, and search for some physical therapy/ stretching excercises on youtube, and when I do those, it helps a lot!"
"I recommend getting a script to see a rheumatologist to make sure there is no underlying condition. a cortisone shot will help it go away right now until the next flare up. however, if you get a cortisone fix, it may not be as easy to figure out what's actually wrong (i've been told, i'm not an expert).
(in my experience):
- physical therapy can help, but only if you do it all the time (at home, after you've learned exercises). if you stop, can experience another flare-up. there is also phys therapy with massage and ultrasound/sonogram therapy. there are hand specialists for this too.
- wearing wristguards while sleeping can help.
- holding babies = yes, totally a reason for a flare up.
I have gone to a couple of hand and wrist doctors, and have had my hands x-rayed but all was fine with bones/ligaments. but b/c my condition was recurring the last one I went to said keep going to the rheumatologist to figure out what's wrong. It can be tendonitis, carpal tunnel, or other issues."
"I feel your pain! I've had 2 bouts of deQuervain's tendonitis (it sounds like that's what you have) aka mommy thumb, aka iphone thumb. I was in so much pain that I skipped the GP route and went right to surgery.
I was very happy with the care I received. I ended up going with a cortisone injection, which completely eliminated my pain within about 2 days of getting it. I was concerned about getting it while nursing, but read some research and felt comfortable with my choice. I also learned that de Quervain's tendonitis is very common in pregnancy and during nursing because of hormonal changes, so it can be difficult to treat if you are still nursing. I also noticed that iphone use really makes it much worse and have tried to cut back. I had a recurrence about 6 months after my injection and got another shot and it has been fine since (fingers crossed)."
"I'd highly recommend physical therapy. I had this condition very early on during pregnancy along with carpal tunnel.
A thumb splint helps rest it and try modifying how you write (use a large pen or add a support around it. Good luck."
"I've been suffering with this now for about 4 months and it's the pits. For me It started shortly after I went back to work when my daughter was 6 months old. I spoke with an ergonomics specialist who readjusted my keyboard, mouse and desk chair, which helped make the pain manageable during the workday. He also recommended wearing a soft wrist brace and applying ice at home--which helps a lot, but the relief is temporary. He also said I could take over-the-counter anti-inflammatory drugs--like aspirin, Motrin, Advil--for the pain. Apparently, use of the wrist brace, regular ice and rest should make the condition go away on its own. If not, there's always steroid shots (which a friend of mine had done at HSS in Manhattan and they worked), and as a last resort, surgery. I've just been toughing it out and trying to be careful of how I pick up the baby."
"I had Mommy Thumb early on and I wore a brace at night (get the kind for wrist issues not hand issues? Or something? It was rigid all the way up to my palm and all the way down past my wrist). My physical therapist said I happened to have the right brace for some reason... they sold it at CVS when I got it. Also, try not moving your wrist when you pick [your child] up, like keep your wrist rigid (you can even wear the brace during the day to help you learn a new way of picking him up)."
"I don't have it in my thumb, but I have horrible pain in my left elbow, that I have identified as related to carrying H&E around, as I always carry them on that side. I try to switch sides, but then I'm worried I'm going to end up with it on both sides :("
"I had wrist pain in both hands, especially at the bases of my thumbs, right>left, about a month postpartum. I made sure to 1) try to keep my wrists in more neutral positions when lifting the baby, bottle feeding, and burping, 2) took an anti-inflammatory pain med (ibuprofen) as needed, and 3) wore my snowboarding wrist guards to bed, so that I was not bending them in my sleep. The pain went away after a couple weeks. If you work at a computer a lot, getting wrist rests for your keyboard and mouse or getting a more ergonomic mouse could also help, if you don't have those things already."
"I also had debilitating pain in my wrists, hands, and thumb joint. I went for an acupuncture treatment but don't know how much it helped as I had to leave town and didn't do any follow up treatments. I got a couple of wrist braces (Futuro brand from Neergard's) which I mostly wore to bed and for short periods during the day when I wasn't holding Phoenix. Wearing the braces also helped me become aware of keeping my wrists in a more neutral position. I also began self- massaging my wrists and hands and sometimes used ice packs. On painful days I would take an occasional Motrin. For the past month I haven't felt the pain at all so hopefully it has worked itself out!"
"All that being said, if you are having numbness, tingling, severe or worsening or persistent pain, or are just very anxious about this, seeing your doctor is the way to go! As a physician I think I tend to self-treat more than I should..----------------I am in the same boat and I also happen to be an OT (but not specifically a hand specialist). When I start feeling tendonitis pain coming on, I really make sure to be aware of my wrist joints and hold them as neutral as possible (as someone else said). Sometimes I even use my hand as leverage by pushing on either my leg or the arm on a chair, or pillow, to offset the pressure on my wrist/forearm (if that makes any sense). So when bottle feeding and lets say Eliana's head is laying near my left elbow/forearm, instead of trying to cradle her and flex my wrist closer around her, I keep my elbow/forearm where they are and extend the wrist (opposite motion) and press the back of my hand lightly against either my leg (if crossed) or against the arm rest of the gliding chair.* I have found this takes the pressure off the wrist immensely (but you have to find what position works for you). And yes, as Meredith said, if there is any type of prolonged, intense or shooting pain that does not subside, definitely see a doctor. The ibuprofen definitely helps for dull/throbbing tendonitis pain/inflammation.
"I would start with your GP, who, after taking a history and doing a physical exam, may 1) recommend a course of treatment right away such as anti-inflammatory medicine, rest/icing/over the counter splinting, or physical therapy, 2) refer you for imaging before making a recommendation, or 3) send you for a consultation/treatment with a physiatrist (physical medicine and rehab doctor) or orthopedist or other sports medicine specialist.
"My big take away from the experience, the thing that helped the most, was to ALWAYS keep my thumb with my hand not apart when I lifted my baby or rode my bike or did anything. It really helped. You start to become conscious of it and realize how often your thumb is apart and the strain that causes."
And some more member recommendations from a June 2020 thread...
"I had this with my first in 2017 and asked PSP about it here are the responses I received then. Also I got the shots and it fixed everything up although now with my second I’m starting to feel it again. I should really get those wrist braces out again before it gets bad.
Here are the doctor's that were recommended: Woodley Desir, Salil Gupta, Michael Rettig, Dr. Vipul Patel, Caryl Johnson (semi retired).
Here are some other pieces of wisdom:
1.
It's really important to vary the positions in which you hold your baby frequently in order to avoid excessive strain on the same muscles & tendons. While a cortisone shot may help in the short term, I think that's something important to remember in the long run. I suppose a good physical therapist (or lactation consultant!) could give you some ideas.
2.
There is a quick test you can do with your hand/wrist, look it up online. If you do have it, happy to chat with you about it as I got it about a month ago and reaches out to the listserv for help and got great responses.
3.
He diagnosed me with De Quervain’s tendonysis, which is also known as “mommy’s wrist/thumb” He gave me a proper wrist brace which helped immobilize my wrist and prevented me from moving it in ways that were painful. He also recommended physical therapy. Next steps would have been a cortisone shot and then surgery if the pain continued.
I would definitely seek out a doctor now. Luckily the pain went away after a few months of wearing the brace constantly (day and night) and icing it/ doing various stretching exercises. But I definitely waited too long and wish I had saved myself months of pain before I finally got around to seeing the doctor.
Good luck! It is NOT easy to deal with this kind of thing along with a new baby!
4.
Yes! I believe the official term is “Mom wrist” :) I have it now and so many of my friends had it. There are a series of wrist stretching and strengthening exercises you can do. I would recommend a Physical Therapist, not a general practitioner. My friend saw one and got some exercises — I don’t know them specifically otherwise I’d share. I just stretch my wrists several times a day and try to consciously adjust my wrist to be in a straight line when holding my baby, as opposed to curled (if that makes sense?). So far, that’s worked for me but if you’re in serious pain, a doc is probably best.
5.
I went to an orthopedist in manhattan and was diagnosed with a rotator cuff injury, tendinitis in my wrist and trigger finger.
All baby related (from lifting/holding and hormones racing thru my body). I never could make the time for physical therapy, but I did start doing some exercises at home and eventually over time, I was back and the pain was gone. (But it took over a year, maybe more.)
So I would find a good orthopedist doctor and start there.
6.
I had this after my son was born. It was bad-really painful. I wore the wrist braces on both sides. Sometimes I took Advil. Oh really rough days I slept with the braces on.
I prob should’ve gone to a dr, but my wife is a physician —ER, so her threshold for actual medical attention is absurdly high. She pulled on a couple of my fingers, asked me where it hurt, told me I had tendinitis from picking up baby combined with hormones, and to take Advil, and went back to reading her magazine. Apparently it’s super common. Honestly there was so much going on those days it didn’t even cross my mind to see a dr or PT. But that seems like a really great idea!
I did really heavily modify the way in which I picked him up, and how I positioned myself while nursing. I paid very close attention to keeping my wrist straight after realizing I was bending it in this funny way. I wore the braces at night on bad days because I realized I was sleeping on my wrist. I also read up on the hormone relaxin, which is excessively flooding your body post partum, and caused me all kinds of minor aches and pains—wrist pain, tooth pain, knee/joint pain—none of which id ever had before.
7.
This may be something called De Quervain’s. I had this and tried wrist splints, hand massage with a hand therapist, etc. for many months in an effort to avoid a cortisone injection (I was concerned about effects on breastfeeding), but the pain was too much and my wrists were not going to improve by themselves, so I eventually got the injection (I saw Dr Rettig with NYU) and the pain was much better just 12 hours later, and continued to improve. A hand orthopedic surgeon is the one to see. I waited way too long and my wrists are not as strong as they used to be. Don’t make that mistake!
8.
I have chronic wrist/hand pain that pops up every couple of years. Get yourself to a hand specialist doctor— I see Dr. salil Gupta in union square— you’ll get a diagnosis, possibly a cortisone shot, and possibly a prescription for hand therapy and/or a hand splint. If you need hand therapy (splinting, exercise, etc), I recommend Allison at Park Sports, but most importantly you’ll need an OT or PT who’s a certified hand therapist, CHT. The most likely diagnosis is DeQuervain’s, but be sure to get it checked out and stop the pain before it gets worse! Best of luck,
9.
I totally understand as I had the same issue with my little one. I went to see Dr. Vipul Patel in park slope. I ended up having to get a steroid shot , which helped a lot. Though my pain is now coming back. It’s just me and my daughter and it’s hard not to have to pick her up all the time.
10.
Yes! It’s literally called mommy thumb :-) I tried a bunch of holistic things (Accupuncture, physical therapy, drinking more water, etc) and none worked. I finally went to the doctor for a cortisone Shot and it went away almost instantly... I highly recommend.
I saw Dr. Rettig at NYU. He’s great —
11.
It’s a common problem called DeQuervain’s or new mother’s tendinitis. I had it in a bad way for a year and a half after my baby was born. I ended up having to have tendinitis surgery, which was quick and instantly effective, but there are many measures to try first. I would recommend a specialist, which in this case I think is called an orthopedist.
One thing I found very useful was to modify my behavior so the weight of the baby was on my arms and wrists as little as possible. I used a breastfeeding pillow to support her and just rested my arms on top of her. I used the stroller more than the baby carrier. I would rest her between my knees and rock/soothe her that way sometimes, to give my arms a break. The biggest and best modification was to always keep my thumbs together with the other fingers and my wrists straight, while lifting her or pushing the stroller handle or carrying the car seat. Parents tend to lift a baby under the armpit with the thumb on the front and the other fingers on the back, and that places a lot of weight and strain on the thumb (and from there to the tendon). It really helped to shift the weight to the whole hand.
Sometimes cortisone shots are also effective."
"Hi! PT here- yes, de quervain’s tenosynovitis is a common issue during pregnancy and postpartum. It’s a condition where you overuse and strain the tendons that control your thumb and wrist. Relaxin hormone makes us prone to injury as our joints are less stable. As suggested above, modifying your form when lifting/carrying the baby , using a brace and doing exercises/stretches are all primary ways of addressing this. I’d also suggest using ice packs to relieve the pain.
There are plenty of different braces available, you just want to make sure that it is Immobilizing the wrist and thumb. The main motion you want to prevent is the thumb moving away from the hand and the wrist bending in the direction of the thumb (aka radial deviation). As an example, this brace would do the trick:
FitPro Adjustable 8" Wrist and Thumb Spica Support With Removable Insert- Left, Small, Amazon Exclusive Brand https://www.amazon.com/dp/B07PR1WMGT/ref=cm_sw_r_cp_api_i_.oK-EbPWS0B1T
When you’re lifting the baby, you can try sliding your hands under him or her to lift using the palm surface of your hand rather than the thumb side. You basically want to avoid reaching your thumb away from your hand during any activities. This site shows a few examples of such activities: http://www.candokiddo.com/news/dequervains
As a side note, this is actually a super helpful resource when it comes to Developmental activities for babies. I used it a lot with my first baby. It’s written by an occupational therapist."
PSP Recommendations:
