‘Mommy thumb:' How to decrease your pain and improve your function

Lifting your sweet bundle of joy thirty-some times each day. Cradling your newborn during nursing or bottle feeds. Performing chores one-handed while holding your fussy baby in your other arm.

What do all these tasks have in common, besides a newborn baby? These can all cause or exacerbate thumb and wrist pain in new moms.

Thumb and wrist pain is so common in the postpartum phase, in fact, that it is commonly coined "mother's thumb" or "mommy thumb." Its formal name is "de Quervain's tenosynovitis” (quite the mouthful).

Symptoms of ‘mommy thumb’ can include pain and swelling near the base of the thumb/on the thumb-side of your wrist, and pain often worsens with increased thumb and wrist movement.

Want to know if you have ‘mommy thumb’?

While not foolproof, the Finkelstein's test can be a sure-fire indication you likely have this condition. 

Place your thumb in the palm of your hand and make a fist around it, then bend your wrist towards your little finger (see picture). If this makes the pain on the thumb-side of your wrist worse, the test is considered positive.

If you have pain during this motion, you quite possibly have ‘mommy thumb.’

Okay...so what causes ‘mommy thumb’?

Repetitive lifting of an object (so often, a baby) with your thumbs abducted from the hand in an "L" shape is what is thought to cause ‘mommy thumb.’ The repetitive motion in this manner causes the tendons which run from your wrist into your thumb to become inflamed and swollen, therefore putting pressure on the "tunnel" that encloses those tendons. This swelling and pressure causes pain over the thumb-side of the wrist; a pain which defines this syndrome.

An example of how not to lift your child if you suspect you have ‘mommy thumb.’

Lifting your child with your thumbs extended out, like in this picture, can actually cause or worsen ‘mommy thumb’ because of the pressure it puts on the thumb-side of your wrist.

While it's an incredibly common result of lifting babies, other repetitive tasks that could cause it include gardening, cooking, cleaning, and racquet sports. I have even helped someone who developed this condition after packing up their home and moving, and another who started experiencing thumb-sided wrist pain following an extensive CPR course.

Modify, modify, modify

Your way out of the pain is figuring out how to change the way you’re doing the activity (or activities) which caused ‘mommy thumb’ in the first place. Changing the way you engage with the activities causing you pain is extremely important in not only eliminating your pain, but preventing it from returning.

A skilled OT can analyze the way you are performing certain activities, and make individualized recommendations on how to modify your actions. I will always recommend receiving skilled occupational therapy if you are experiencing pain, but if you find that's outside of your time or budget try the following simple tips.

Concentrate on changing the way you lift your baby. Rather than pulling your thumbs out and lifting your child under the armpits, instead try scooping your baby under their bottom and back with both hands, keeping your palms up and wrists/thumbs in a neutral position.

Moms who breastfeed their babies, in particular, can be forced into more awkward wrist/hand positioning. While holding/nursing your child in awkward positions doesn't necessarily CAUSE "mommy thumb," it can certainly increase the pain once it's there. Plus, practicing good ergonomics is beneficial and can prevent other injuries/conditions such as a sprain or carpal tunnel syndrome. You could try a nursing pillow such as "My Brest Friend;" however, many lactation consultants are saying to ditch the nursing pillows altogether and instead find a seat you can recline in, which takes the strain off your hands/wrists because baby is supported by your body instead (and it’s also healthier for your back!).

Another activity which could provoke the pain is pushing a stroller, and parents with painful wrists/thumbs could consider using their forearms to push the stroller on flat ground.

If you're a parent or caregiver blessed with a baby who never wants you to put him or her down (I am so sorry if you are...our first baby was one of these. It gets easier, I promise.), you may find yourself doing everything one-handed as you hold your fussy child in your other arm. Chores, cooking, getting dressed, etc. were never meant to be performed one-handed while holding a baby in the other hand! This is begging to 1) get burnt out, and 2) develop a good case of "mommy thumb." Babywearing will become your saving grace if your baby insists on being close to you at all hours. I love a good, classic Moby Wrap for colder months; but if you find yourself overheating in this cloth-heavy wrap, consider the Lalabu Soothe Shirt. It's literally as easy as putting your baby in your shirt!! I found it very helpful for our subsequent children - when I was already running around after my toddler, it was easy to just put baby right in my shirt!

As your newborn grows, the above baby carriers will not feasibly hold your chunky, growing baby. When baby is 3-4 months old, I have generally transitioned them to my Ergobaby carrier. It's very supportive, comfortable, and ergonomic (as the name would imply!).

Consider decreasing your hand strain during other non-caregiving tasks. Now is the time to purchase that roomba vacuum, automatic toilet bowl cleaner, and multipurpose food chopper. Any gadget that you can find that will allow your hands to rest is going to be your best friend.

When modifying isn't feasible or enough

Sometimes, it's difficult to modify an activity enough that it doesn't put ANY strain on your painful, inflamed thumb/wrist. Usually, this is why I recommend activity modification paired with some form of thumb support.

A thumb/wrist immobilization splint can calm the area down enough to decrease swelling and pain, but it’s often not feasible to wear this all day every day, especially if you have to care for a new baby.

Try out kinesiotape! I break down exactly how to use kinesiotape on your thumbs/hands in this video.

Hand, wrist, and forearm stretches and exercises are usually initiated under the instruction of a skilled occupational therapist after the pain and swelling have decreased. The type, frequency, and duration of each exercise depend on the individual and it is recommended to only perform them under instruction of an OT or PT.

If these conservative measures have failed, a doctor may recommend a corticosteroid injection into the site of swelling and pain. In the most significant cases, a doctor may need to surgically release the area; however, most individuals with de Quervain's or ‘mommy thumb’ will heal with therapy and/or a steroid injection.

If you are struggling with hand pain and aren’t sure where to start, make sure you check out my free support guide for either hypermobile hands or hand arthritis. I didn’t even know I had hypermobile hands until I had ‘mommy thumb’ and realized my hypermobility was actually a large contributor to my ‘mommy thumb’ pain.