OUCH - what is that? You're lifting your 4 week old out of the car seat after a brave solo excursion to the grocery store when you feel a pain on the thumb-side of your wrist.
OUCH! Seriously - what is that? You're in the middle of fastening all 47 snaps on your 5 week old's pajamas, trying desperately in your sleep deprived fog to align them correctly when - *WINCE* - the base of your your thumb hurts with every one.
Parenting an infant is hard enough without hand or wrist pain nagging during nearly every baby-related task. What is that pain? And how can you get it to go away or stop it before it starts?
"Mommy Thumb," "Dishwasher's Thumb," "Texting Thumb" - all nicknames for DeQuervain's Tenosynovitis, a very common hand pain for new moms. And while Mommy thumb is indeed very common in new mothers, I think a more apt name would be, "Mommy-doesn't-have-time-to-be-in-pain Thumb."
DeQuervain's is basically caused by angry tendons that operate your thumb. The most common symptoms are pain, tenderness and swelling at the base of the thumb and on the thumb-side of the wrist. You may notice certain positions or movements bring on the pain or you may be more aware of a general aching that lingers throughout the day (and night).
Why New Moms Are At Very High Risk For DeQuervain's
This type of thumb and wrist pain isn't unique to new mothers, but we're at particularly high risk. Here's why:
We do many, many repetitive tasks. Let's face it - new motherhood is basically an endless cycle of the same tasks over and over.
Our mothering "work" is never done. Unlike job-related repetitive tasks, mothering doesn't have a clock-out time. That means that the tendons involved in DeQuervain's Syndrome don't ever get a break to rest and heal.
We have a unique hormonal profile. Pregnancy and postpartum hormones put us at higher risk of joint conditions like DeQuervain's Syndrome (and also Carpal Tunnel Syndrome).
What we do when we're not tending to baby. Laundry, cooking, dishes, cleaning - doesn't sound much like a break, does it? But for many new moms, downtime from baby care doesn't mean putting our feet up and eating bonbons. Instead, there are even more repetitive tasks putting high demands on our hands.
Our little screens. Since having a new baby has your cell phone or tablet become your primary portal to the outside world? I found that I spent waaaay more time scrolling and texting than ever before when I was caring for my newborns. Unfortunately, the hand position of cell phone use contributes to DeQuervain's.
The Bad News: Standard Treatments
There's good news and bad news. The bad news is that many of the standard treatments for DeQuervain's Syndrome are difficult or impossible for new moms to comply with. Let's look at a few:
Splinting: Even if you could make it to a splinting appointment on time with an infant in tow you'd very likely be sent home with a hard plastic splint (the nerdy therapist term is "thermoplast"). The goal of splinting is to hold your thumb in one position and let those tendons rest, but a hard plastic splint basically gets in the way of every mothering task you have to do. It's also not so warm and fuzzy to cuddle a newborn with a hard plastic thumb splint. While not as effective, a softer neoprene splint might be something to speak to your healthcare provider about.
Hand Therapy: While hand therapy can be effective, recurring appointments with a newborn just aren't practical for many new moms from a time and money standpoint. If they were, a whole lot more of us would be getting weekly massages!
Time off from work or reduced workload: Ha!
Oral Anti-inflammatory medicine: This treatment option may be very helpful for some new moms but requires some special consideration. Some medicines are safe for nursing mothers but others aren't, so be sure to discuss breastfeeding with your doctor if that's a factor. And you may need to set a medication reminder alarm on your phone or watch - remembering to take medicine throughout the day is a tall order for someone who may still struggle to remember if she ate lunch. Injected anti-inflammatories are another unpopular but effective option to manage pain.
Surgery: Now that you have a new baby to care for, it would have to be a pretty desperate situation for you to elect to have hand surgery.
The Good News: Simple Changes For Big Results
The good news is twofold: (1) As your baby gets older and more mobile, your symptoms will likely decrease, and (2) changing how you complete some of your childcare dailies (or hourlies) can help prevent and/or reduce the symptoms of DeQuervain's Syndrome.
1. Be a Bulldozer, Not a Forklift
Admittedly I spend much of my day playing "diggers" with my toddler. But it helped me come up with this silly visual...
The most natural way to lift your baby is two hands under the armpits with thumbs up - sort of like a forklift. This is one of the most exacerbating actions for DeQuervain's. Instead, as often as possible, remember to keep your thumbs in line with your other fingers and lift with palms up in a scooping motion, like the bucket of a bulldozer.
2. Avoid Crazy Wrist Positions
If you start paying attention, you'll very likely notice that we moms can get our wrists into some pretty extreme positions during baby care. And if those bent positions are the ones that allow our kiddos to drift off to sleep or happily take a bottle, we aren't apt to change them.
Try to take note of your wrist position as you hold or carry your baby, nurse or bottlefeed and rock or pat your babe to sleep, push your stroller or carry your infant car seat carrier and make changes to avoid extreme bending. In nerdy therapy speak, we call this trying to maintain a "neutral wrist position."
3. Change Things Up
If you already have pain, notice what activities seem to make it worse. Then brainstorm ways to change how you accomplish those tasks. One of the biggest aggravators of my new mom hand pain was hoisting the diaper bag onto my shoulder. I realized that I always did this using the same arm that I was going to wear the bag on (usually because baby was in the other arm).
It seems so simple, but it took a few weeks to break my painful habit and start using the other hand (in a much more neutral wrist and thumb position) to put the "DB" (as we call it in our house) on my shoulder.
There is no "sitting on the sidelines" in mothering, no "injured list" to wait on until you're ready to get back into the game. So, often, our only choice is to make the changes to our daily routines needed to tackle our wrist and hand pain head on. As always, consult your physician for individualized medical advice.
4. Use Simple Tools To Avoid Pain
There are soooo many amazing tools available to help you get non-childcare related tasks done with less pain and irritation. Kitchen tools, buttoning tools and more are available and an Occupational Therapist can be a huge help for trying and choosing the right tools for the job.
But adaptive tools for baby care are almost unheard of...until now. I love the idea a fellow OT had for creating a gadget to make unbuckling a car seat easier, especially since my own mom (who has arthritis in her thumbs) truly can't unbuckle my kids without help. If you're experiencing pain or difficulty unbuckling your kiddo's car seat, be sure to check out UnBuckle Me!