The Gist: What is DeQuervain’s tenosynovitis?
Also known as: Mommy thumb, mother's wrist, gamer's thumb, or texter's thumb.
DeQuervain's tenosynovitis is an overuse injury of the thumb and hand caused by repetitive motion. It often occurs among new moms several weeks after delivery due to increased stress when holding and feeding newborns, and typically worsens as the baby grows.
If you have DeQuervain's tenosynovitis, the base of your thumb will become painful, swollen, and inflamed. In severe cases, the swelling can put pressure on the nerves going into the thumb, causing numbness or tingling. Pain and symptoms increase the more you use your wrist and hand, and typically decrease with rest. However, symptoms can be constant in severe cases.
Anatomy of DeQuervain’s tenosynovitis
The extensor retinaculum is a connective tissue band that covers the two tendons that sit on the side of your wrist at the base of your thumb. These two tendons are the extensor pollicis brevis (EPB) and abductor pollicis longus (APL), which make up the walls of your "anatomical snuff box." You can easily find your anatomical snuff box at the base of your thumb when you spread your fingers as wide as possible. DeQuervain's Tenosynovitis is the inflammation of the extensor retinaculum, which causes subsequent irritation to the tendons that pass beneath it.
Who gets DeQuervain’s tenosynovitis? When does it occur for women?
DeQuervain's tenosynovitis is caused by the repeated action of radial deviation, or moving your wrist in the direction of your thumb. New moms are constantly doing that movement while holding, feeding, and scooping their babies. Scooping refers to the act of picking up your baby by scooping your hands under the armpits and lifting the baby toward you. New moms can start experiencing DeQuervain's tenosynovitis a few weeks after delivery, but symptoms can arise later as the baby is getting bigger.
The Origin Way: Physical therapy for DeQuervain’s tenosynovitis
At Origin, we treat DeQuervain's tenosynovitis with a comprehensive approach. Using a combination of manual therapy, exercises, and education, we aim to find and address the root cause of the condition and treat it by making more meaningful and global changes to the way you move. Even if you are coming in with thumb pain, we will also screen your abs and address any other concerns you may have. A mama is more than just her thumb!
A typical plan of care
A typical plan of care includes manual therapy techniques to the wrist, hand, and forearm, as well as flexibility and strengthening exercises for the hand and wrist. Your Physical Therapist may apply therapeutic kinesiology tape to your wrist or recommend a brace to improve stability.
In addition, they will provide education and strategies for using your wrist and hand, particularly during lifting and other childcare tasks. Our goal for you is whatever your goals are, but, we definitely want you to be able to use your wrist without pain.
How long does it take?
Typically, you will see your Physical Therapist 1-2 times per week for 4-6 weeks. After 6 weeks if you do not feel improvement, your Physical Therapist will send you back to your doctor to discuss less conservative treatment options like cortisone injections or, in the most severe cases, surgery.
What to expect in the future
The ultimate goal is to get you out of pain, and using your wrist and hand normally again. Once the pain has subsided, it typically will not come back if you continue to implement the strategies you learned during physical therapy.
If you are pregnant again and have a history of DeQuervain's tenosynovitis, the hope is that you can proactively start your exercises and lifting techniques to prevent it from recurring. The goal of starting your care at Origin is to avoid more aggressive forms of treatment, like surgery.
Additional Reading and Sources
Rabin, Alon, et al. "Physiotherapy Management of People Diagnosed with De Quervain's Disease: A Case Series." Physiotherapy Canada. Physiotherapie Canada, University of Toronto
Press, Aug. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4594817/
Papa, John A. "Conservative Management of De Quervain's Stenosing Tenosynovitis: a Case Report." The Journal of the Canadian Chiropractic Association, Canadian Chiropractic Association, June 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3364060/