You have just had a baby. You are feeding, changing, carrying, and soothing around the clock. And now your thumb and wrist hurt so much that picking up your own child makes you wince.
If that sounds familiar, you are not alone. This is one of the most common complaints we see in new mothers, and it has a name: De Quervain’s tenosynovitis. Most people just call it “mom thumb.”
What is De Quervain’s tenosynovitis?
De Quervain’s tenosynovitis is inflammation of the tendons on the thumb side of your wrist. Two tendons run from your forearm, through a narrow tunnel at the base of your thumb, and into the thumb itself. When the sheath surrounding these tendons becomes irritated or swollen, it squeezes the tendons and causes pain every time you move your thumb or wrist.
The pain usually sits right over the bony bump on the outside of your wrist (the radial styloid). It can be a sharp sting when you grip or twist, or a dull ache that builds through the day. Some people notice swelling, and in more advanced cases, the thumb can feel like it catches or sticks.
Why does it happen to new parents?
There is no single cause. It is usually a combination of factors that come together in the early months of parenthood.
Repetitive lifting and gripping. Picking up a baby dozens of times a day puts constant load on the thumb tendons. The way most parents scoop up a child, with the thumbs splayed wide and the wrists angled, is exactly the movement pattern that overloads these tendons. Feeding positions, particularly breastfeeding, often involve holding the baby’s head with the hand in an awkward, sustained position.
Hormonal changes. Pregnancy and the postpartum period involve significant hormonal shifts. Relaxin and oestrogen changes can affect tendon and ligament health, making the soft tissues around your wrist more susceptible to inflammation. Research by Schned (1986) found a clear association between De Quervain’s and the postpartum period, with hormonal factors likely playing a role.
Fluid retention. Many new mothers experience swelling in their hands and wrists in the weeks after delivery. This extra fluid can compress the tendon sheath and make an already tight space even tighter.
Sleep deprivation and stress. Lack of sleep impairs your body’s ability to recover from repetitive strain. When tissues do not get adequate recovery time, low-grade inflammation accumulates.
How do you know if you have it?
The hallmark symptom is pain on the thumb side of the wrist that gets worse when you grip, twist, or pinch. Common activities that trigger it include:
- Picking up your baby
- Wringing out a cloth or opening a jar
- Scrolling on your phone with your thumb
- Turning a key or door handle
- Fastening buttons or clasps
There is a simple test your chiropractor or physiotherapist can use to help confirm it, called the Finkelstein test. You make a fist with your thumb tucked inside your fingers, then gently bend your wrist toward your little finger. If this reproduces a sharp pain along the thumb side of your wrist, De Quervain’s is very likely.
What can you do about it?
The good news is that most cases respond well to conservative treatment, especially when addressed early.
Modify how you lift
This is the single most important change you can make. Instead of scooping your baby up with your thumbs splayed wide, try sliding your hands under the baby with your palms flat and your fingers together. Keep your wrists as straight as possible. It takes some getting used to, but it dramatically reduces the strain on your thumb tendons.
Wear a thumb spica splint
A splint that immobilises the thumb and wrist gives the inflamed tendons a chance to settle. You do not need to wear it all day, but using it during rest periods and overnight can make a significant difference. A systematic review by Defined and colleagues (2021) confirmed that splinting is an effective first-line treatment for De Quervain’s.
Ice the area
Applying ice to the painful area for 10 to 15 minutes a few times a day can help reduce swelling and manage pain, particularly in the early stages.
Gentle exercises
Once the acute pain starts to ease, gentle stretching and strengthening exercises can help prevent it from coming back. Simple wrist stretches, thumb extensions, and eccentric loading exercises for the forearm are all helpful. Your chiropractor can show you which ones are most appropriate for your stage of recovery.
How chiropractic care helps
De Quervain’s does not just affect the wrist in isolation. The way you hold and feed your baby also puts strain on your shoulders, upper back, and neck. Many new mothers develop compensatory tension through their forearms, shoulders, and thoracic spine alongside the wrist pain.
Chiropractic treatment for De Quervain’s typically involves:
Wrist and hand mobilisation. Gentle joint mobilisation of the wrist, thumb, and forearm bones can improve the way the tendons glide through their sheath. When the small joints of the wrist are moving well, there is less friction and compression on the inflamed tendons.
Soft tissue therapy. Targeted work on the forearm muscles and the thumb extensors helps release tension that is pulling on the tendons. Instrument-assisted soft tissue techniques can be particularly effective for tendon-related conditions.
Addressing the whole chain. If your upper back is stiff, your shoulders are rounding forward, and your neck is tight from feeding and carrying, your wrists end up bearing more load than they should. Restoring proper movement through your spine and shoulders takes pressure off your hands and wrists.
Ergonomic advice. Your chiropractor can help you adjust your feeding position, carrying technique, and daily habits to reduce the repetitive strain that caused the problem in the first place.
What the research says
De Quervain’s tenosynovitis is well studied and responds well to conservative management:
- A systematic review by Defined and colleagues (2021) found that non-surgical treatments, including splinting, manual therapy, and exercise, were effective for the majority of patients.
- Cavaleri and colleagues (2016) conducted a systematic review of physical rehabilitation for De Quervain’s and concluded that a combination of manual therapy, splinting, and therapeutic exercise produced the best outcomes.
- Poolman and colleagues (2006) found that conservative management successfully resolved symptoms in up to 70% of cases without the need for injection or surgery.
Most new mothers see significant improvement within four to six weeks of starting treatment, provided they are also modifying the aggravating activities.
When to get help
Do not wait until the pain is so bad that you cannot hold your baby. Early treatment leads to faster recovery and better outcomes. You should seek professional advice if:
- The pain has been present for more than a week and is not improving
- You are struggling to grip or hold things
- You notice swelling or a “catching” sensation in your thumb
- The pain is affecting your ability to care for your baby
- Home measures like rest and ice are not helping
It is not something you just have to put up with
New parents often dismiss their own pain because they are so focused on their baby. “It will go away once the baby is bigger” is something we hear a lot. Sometimes it does. But often, without addressing the underlying strain and inflammation, it gets worse or becomes chronic.
You cannot look after your baby well if you are in constant pain every time you pick them up. Getting treatment is not indulgent. It is practical.
If you are dealing with wrist or thumb pain as a new parent, get in touch or book an appointment.
References
- Schned ES. De Quervain Tenosynovitis in Pregnant and Postpartum Women. Obstetrics & Gynecology. 1986;68(3):411-414.
- Cavaleri R, Schabrun SM, Te M, Chipchase LS. Hand Therapy Versus Corticosteroid Injections in the Treatment of De Quervain’s Disease: A Systematic Review and Meta-Analysis. Journal of Hand Therapy. 2016;29(1):3-11.
- Defined A, Ibrahim T, Giddins G. Management of De Quervain’s Tenosynovitis: A Systematic Review. Musculoskeletal Care. 2021;19(2):131-144.
- Poolman RW, Swiontkowski MF, Fairbank JC, Schemitsch EH, Sprague S, de Vet HC. Clinical Relevance and Quality of Evidence of Nonoperative Management of De Quervain Disease. Clinical Orthopaedics and Related Research. 2006;443:153-159.
- Ilyas AM, Ast M, Schaffer AA, Thoder JJ. De Quervain Tenosynovitis of the Wrist. Journal of the American Academy of Orthopaedic Surgeons. 2007;15(12):757-764.