Thumb Problems in the New Mom

Eyewitness News—North Carolina—August 11, 2006

Some new moms complain of pain in the thumb, wrist, or forearm. The condition has been dubbed “mom’s thumb,” but is also known as de Quervain’s tendonitis or “baby wrist.” It occurs because women tend to cradle the head of the baby in the palms of their hands, extending the thumb to provide extra support for the head. The unusual repetitive positioning and weight of the baby put pressure on the tendons at the base of the thumb, causing irritation and inflammation.

Women may complain of pain along the wrist that can radiate down the thumb or up the arm. Grasping or pinching with the affected hand increases the pain sensation. Some women develop a swelling on the base of the thumb. The symptoms may occur gradually or suddenly.

Traditional treatment for “mom’s thumb” is to immobilize the affected thumb and wrist by wearing a splint. Ice and oral anti-inflammatory medications may help reduce inflammation.

Ronald Adler, M.D., Ph.D., chief, Division of Ultrasound and Body CT, Department of Radiology and Imaging, at Hospital for Special Surgery, says injections of cortisone may also be helpful. The patient is first given a local anesthetic. Then, using ultrasound for guidance, cortisone medication is injected into the tendon compartment. The anesthesia and injection help reduce pain and swelling. Some patients may need over-the-counter pain medications and ice for about a day until the cortisone starts taking effect. Many women have complete recovery after the injection. A small number experience relief for a few months and require a second injection later.

Research shows about 77 percent of women with “mom’s thumb” get relief with conservative treatments. When symptoms don’t go away or are severe, surgery may be recommended. The goal of the surgery is to enlarge the space in the tendon compartment to allow the inflamed tendon to move more easily.

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